*Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Jpn J Clin Oncol. 2013 Oct;43(10):1012-7. doi: 10.1093/jjco/hyt108. Epub 2013 Aug 1.
The aim of the study was to investigate the outcomes of high-dose-rate interstitial radiation therapy for patients with Stage I and II mobile tongue cancer retrospectively.
Sixty-seven patients with Stage I and II mobile tongue cancer were treated with high-dose-rate interstitial radiation therapy, with or without external beam radiation therapy, between 1997 and 2007. The median dose of interstitial radiation therapy was 50 Gy in 10 fractions over 6 days. Thirty-five patients received external beam radiation therapy before interstitial radiation therapy. The median dose of external beam radiation therapy was 20 Gy delivered with single-lateral or bilateral fields, including the primary tumor site and upper jugular lymph nodes. Thirty-seven patients received concurrent chemotherapy, including carboplatin, cisplatin, fluorouracil or tegafur, gimeracil and oteracil (TS-1) systemically or with intra-arterial injection. Thirty-three patients received intratumoral injection of bleomycin before catheter insertion. The median follow-up time was 58.6 months (range 15.1-102.4 months).
The 5-year overall, cause-specific, progression-free survival rate and local control rate were 88.7, 92.1, 76.0 and 94.0%, respectively. Fourteen patients developed cervical lymph node recurrence, 11 of which were distributed within the external beam radiation therapy field. We found local failures in four cases within 2 years after the treatment and in three cases after >7 years, even though the latter were difficult to distinguish from second primary cancers.
The treatment results of our institutions were equivalent to previous reports. Most cervical lymph node metastases occurred within the external beam radiation therapy field, which implied that the external beam radiation therapy dose of 20-30 Gy was insufficient to prevent late cervical lymph node metastases.
本研究旨在回顾性分析Ⅰ期和Ⅱ期活动型舌癌患者接受高剂量率间质内放疗的疗效。
1997 年至 2007 年间，我们对 67 例Ⅰ期和Ⅱ期活动型舌癌患者采用高剂量率间质内放疗联合或不联合外照射治疗。间质内放疗的中位剂量为 50Gy/10 次，5 天完成。35 例患者在间质内放疗前接受外照射治疗，中位剂量为 20Gy，采用单侧或双侧照射野，包括原发灶和上颈淋巴结。37 例患者接受同期化疗，包括顺铂、卡铂、氟尿嘧啶或替加氟、吉美嘧啶和奥替拉西（TS-1）系统或动脉内注射。33 例患者在置管前行瘤内注射博来霉素。中位随访时间为 58.6 个月（15.1-102.4 个月）。
5 年总生存率、无瘤生存率、无进展生存率和局部控制率分别为 88.7%、92.1%、76.0%和 94.0%。14 例患者发生颈淋巴结转移，其中 11 例分布在外照射野内。我们发现 4 例患者在治疗后 2 年内出现局部复发，3 例患者在治疗后>7 年内出现局部复发，尽管后者很难与第二原发癌区分。
本机构的治疗结果与既往报道相当。大多数颈淋巴结转移发生在外照射野内，提示 20-30Gy 的外照射剂量不足以预防晚期颈淋巴结转移。
