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口腔癌患者高剂量率组织间近距离放疗的临床结果

Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer.

作者信息

Lee Sung Uk, Cho Kwan Ho, Moon Sung Ho, Choi Sung Weon, Park Joo Yong, Yun Tak, Lee Sang Hyun, Lim Young Kyung, Jeong Chi Young

机构信息

Proton Therapy Center, National Cancer Center, Goyang, Korea.

Proton Therapy Center, National Cancer Center, Goyang, Korea. ; Center for Specific Organs Cancer, National Cancer Center, Goyang, Korea.

出版信息

Radiat Oncol J. 2014 Dec;32(4):238-46. doi: 10.3857/roj.2014.32.4.238. Epub 2014 Dec 30.

DOI:10.3857/roj.2014.32.4.238
PMID:25568852
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4282998/
Abstract

PURPOSE

To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer.

MATERIALS AND METHODS

Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using (192)Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions.

RESULTS

The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT ± external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (≤grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention.

CONCLUSION

HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.

摘要

目的

评估高剂量率（HDR）组织间近距离放射治疗（IBT）在口腔癌患者中的临床疗效。

材料与方法

回顾性分析2001年至2013年间16例接受（192）铱 HDR 遥控后装近距离放射治疗的口腔癌患者。11例患者将近距离放射治疗作为主要治疗手段，5例患者用于初始手术后复发的挽救性治疗。12例患者接受外照射放疗（50 - 55 Gy/25次分割）联合21 Gy/7次分割的 IBT。此外，3例患者将 IBT 作为唯一治疗手段，总剂量为50 Gy/1次分割，1例患者作为术后辅助治疗，总剂量为35 Gy/7次分割。

结果

全组5年总生存率为70%。3年后精算局部控制率为84%。所有5例初始手术后复发的病例均通过 IBT ± 外照射放疗成功挽救。2例患者分别在 IBT 后3个月和5个月出现局部复发。急性并发症可接受（≤2级）。3例患者出现严重晚期并发症，如放射性骨坏死，其中1例患者接受保守治疗，2例需要手术干预。

结论

HDR IBT 治疗口腔癌在多种临床情况下，如原发性或挽救性治疗中，是有效且可接受的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08a/4282998/e61c67c00c57/roj-32-238-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08a/4282998/7dd22c9a5071/roj-32-238-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08a/4282998/e9c2b4209fe1/roj-32-238-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08a/4282998/64714b188065/roj-32-238-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08a/4282998/e61c67c00c57/roj-32-238-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08a/4282998/7dd22c9a5071/roj-32-238-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08a/4282998/e9c2b4209fe1/roj-32-238-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08a/4282998/64714b188065/roj-32-238-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f08a/4282998/e61c67c00c57/roj-32-238-g004.jpg

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