Vedasoundaram Parthasarathy, Prasanna Aravind Kumar, Ks Reddy, Selvarajan Gangothri, Sinnatamby Mourougan, Ramapandian Seenisamy, Kandasamy Saravanan
Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India.
Medical Physicists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Springerplus. 2014 Oct 9;3:590. doi: 10.1186/2193-1801-3-590. eCollection 2014.
The study aimed to assess the effect of High Dose Rate (HDR) Interstitial Brachytherapy when used alone or in combination with External Beam Radiotherapy (EBRT), in early and locally advanced squamous cell carcinoma of buccal mucosa.
Thirty three patients with histologically proven squamous cell carcinoma of the buccal mucosa received high dose rate interstitial brachytherapy either as primary treatment or as a boost from November 2008 to April 2013. Stage I patients received interstitial brachytherapy alone to a dose of 38.50 Gy, 3.5 Gy per fraction, twice daily at six hours apart for 11 fractions. Stage II patients received EBRT to a dose of 50 Gy in 25 fractions of two Gy each followed by brachytherapy boost to 21 Gy, 3.5 Gy per fraction, twice daily at six hours apart for six fractions. Stage III patients received the same radiotherapy schedule (i.e., same EBRT & Brachytherapy schedule) and with addition of Injection Cisplatin 70 mg/m(2) in three divided doses every three weeks along with EBRT.
Follow up ranged from 12 to 60 months, median follow up was 26 months. Complete response was observed in 28 patients. Five patients had residual disease and were referred for surgical salvage. One patient died of disease progression. Stage I patients had 100% local control, whereas Stage II and Stage III patients had 84.6% and 80% local control respectively.
HDR Interstitial Brachytherapy used either as a primary treatment modality or as a boost in buccal mucosal cancers provides results comparable to that of surgery, with the advantages of organ preservation, better cosmetic and functional outcomes.
本研究旨在评估高剂量率（HDR）组织间近距离放射治疗单独使用或与外照射放疗（EBRT）联合使用时，对早期和局部晚期颊黏膜鳞状细胞癌的疗效。
2008年11月至2013年4月，33例经组织学证实的颊黏膜鳞状细胞癌患者接受了高剂量率组织间近距离放射治疗，作为主要治疗或强化治疗。I期患者单独接受组织间近距离放射治疗，剂量为38.50 Gy，每次分割剂量为3.5 Gy，每天两次，间隔6小时，共11次分割。II期患者先接受EBRT，剂量为50 Gy，分25次分割，每次2 Gy，随后进行组织间近距离放射治疗强化，剂量为21 Gy，每次分割剂量为3.5 Gy，每天两次，间隔6小时，共6次分割。III期患者接受相同的放疗方案（即相同的EBRT和组织间近距离放射治疗方案），并在EBRT期间每三周分三次注射顺铂70 mg/m²。
随访时间为12至60个月，中位随访时间为26个月。28例患者观察到完全缓解。5例患者有残留疾病，被转诊进行手术挽救。1例患者死于疾病进展。I期患者的局部控制率为100%，而II期和III期患者的局部控制率分别为84.6%和80%。
HDR组织间近距离放射治疗作为颊黏膜癌的主要治疗方式或强化治疗，其效果与手术相当，具有保留器官、美容和功能效果更好的优点。
