Furdová A, Lukačko P, Lederleitner D
Cesk Slov Oftalmol. 2013 Jun;69(2):75-9.
First experience and evaluation of relapses in group of patients after surgery with applied adjuvant HDR brachytherapy for recurrent tumor after incomplete excision of basal cell carcinoma of the lower eyelid and inner angle.
Patients with recurrent basal cell carcinoma of the lower eyelid in year 2010. In 3 male patients with recurrent finding of basal cell after surgery we applied adjuvant HDR 192Ir brachytherapy. The isodose curve chosen to prescribe the dose was 5 mm away from the skin surface.
In the year 2010 we applied adjuvant HDR 192Ir brachytherapy in 3 male patients with recurrent basal cell carcinoma. The average age was 58 years (52 to 75 years). From group of 41 patients with non melanotic malignant tumors of the eyelids in 3 patients (7.3 %) with relapse after incomplete excision of the basal cell carcinoma of the lower eyelid we applied after removal of stitches after surgery adjuvant HDR 192Ir brachytherapy. For each patient was made individual orfit mask that bore plastic applicators. Tungsten eye shield applicator was applied to protect the eye globe. Treatment of 10 fractions of 4.5 Gy single dose (5 times weekly) were scheduled within 2 weeks. Patients received outpatient treatment.
Acute toxicity postradiation erythema of eyelid and skin around relieved by standard symptomatic treatment within a few days after completion of radiation therapy. In 2 year interval after HDR 192Ir brachytherapy we did not record the occurrence of late complications such as corneal ulcers. Our preliminary experience shows excellent early skin tolerance. After 2 years of follow-up at 6 month interval we did not recognize relapse in our group of patients. The proposed technique of HDR 192Ir brachytherapy after surgery should be considered a new clinical treatment in patients with recurrent non melanotic eyelid cancer. Its main advantage lies in the usefulness in all types of basal cell and squamous cell carcinoma and sebaceous carcinoma of the eyelids, without restriction by site, dimension, clinical or histological type, or the patients general status.
对下睑及内眦基底细胞癌切除不完全后复发肿瘤患者行辅助高剂量率近距离放疗手术后复发情况进行首次经验总结及评估。
选取2010年下睑复发性基底细胞癌患者。3例男性患者术后复发基底细胞，对其应用辅助高剂量率铱-192近距离放疗。规定剂量的等剂量曲线距皮肤表面5毫米。
2010年对3例复发性基底细胞癌男性患者应用辅助高剂量率铱-192近距离放疗。平均年龄58岁（52至75岁）。在41例眼睑非黑素性恶性肿瘤患者中，3例（7.3%）下睑基底细胞癌切除不完全后复发，术后拆线后对其应用辅助高剂量率铱-192近距离放疗。为每位患者制作带有塑料施源器的个体化适配面罩。应用钨质眼罩施源器保护眼球。计划在2周内分10次给予单次剂量4.5 Gy（每周5次）的治疗。患者接受门诊治疗。
放疗后眼睑及周围皮肤的急性毒性红斑在放疗结束后数天内通过标准对症治疗得以缓解。在高剂量率铱-192近距离放疗后的2年间隔期内，未记录到角膜溃疡等晚期并发症的发生。我们的初步经验显示早期皮肤耐受性良好。在间隔6个月进行2年随访后，我们的患者组未发现复发。术后高剂量率铱-192近距离放疗技术应被视为复发性非黑素性眼睑癌患者的一种新的临床治疗方法。其主要优势在于对所有类型的眼睑基底细胞癌、鳞状细胞癌和皮脂腺癌均有效，不受部位、大小、临床或组织学类型或患者一般状况的限制。
