Department of Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan.
J Radiat Res. 2013 Nov 1;54(6):1125-30. doi: 10.1093/jrr/rrt060. Epub 2013 May 17.
Brachytherapy using (198)Au grains is minimally invasive and the only curative treatment for early tongue cancer in patients of advanced age or poor performance status available in our institution. From March 1993 to February 2008, (198)Au grains were used to treat a group of 96 Stage I-II tongue cancer patients who could not undergo surgery or brachytherapy using (192)Ir pins because of an advanced age (≥75 years) or poor performance status (≥2). The patients were followed for 3.9 ± 3.3 years, and the cause-specific survival and local control rates were determined. Survival analyses were performed using the Kaplan-Meier method, and univariate and multivariate analyses were performed using the Cox proportional hazard model. The results were compared with those for a group of 193 early tongue-cancer patients who underwent treatment using iridium pins. The 5-year cause-specific survival and local control rates of the (198)Au grains group were 71% and 68%, respectively, both of which were 16% lower than the corresponding rates for the (192)Ir pins group. Our study demonstrated that as the last curative treatment available, (198)Au grain implantation could be used to achieve moderate treatment results for early tongue cancer in patients of advanced age or poor performance status.
（198）Au 颗粒放射性近距离治疗是一种微创治疗方法，也是我院对于高龄或体能状态不佳的早期舌癌患者唯一可提供的治愈性治疗手段。自 1993 年 3 月至 2008 年 2 月，我们对 96 例Ⅰ期-Ⅱ期舌癌患者采用（198）Au 颗粒进行治疗，这些患者因高龄（≥75 岁）或体能状态不佳（≥2 分）而无法进行手术或（192）Ir 针近距离治疗。患者的随访时间为 3.9±3.3 年，确定了其疾病特异性生存率和局部控制率。采用 Kaplan-Meier 方法进行生存分析，采用 Cox 比例风险模型进行单因素和多因素分析。并将结果与 193 例采用铱针治疗的早期舌癌患者的结果进行了比较。（198）Au 颗粒组的 5 年疾病特异性生存率和局部控制率分别为 71%和 68%，均比（192）Ir 针组低 16%。我们的研究表明，（198）Au 颗粒植入作为最后一种可提供的治愈性治疗手段，可用于治疗高龄或体能状态不佳的早期舌癌患者，获得中等治疗效果。
