Pimenta Ana, Gutierrez Cristina, Mosquera David, Pera Juan, Martínez Evelyn, Londres Bradley, Pino Francisco, Moreno Sergio, Garcia Marc, Guedea Ferran
Serviço de Radioterapia, Instituto Português de Oncologia Francisco Gentil, EPE, Lisbon, Portugal.
Servicio de Oncología Radioterápica, Instituto Catalán de Oncologia - Barcelona, Avinguda Granvia de l'Hospitalet, Barcelona, Spain.
Brachytherapy. 2015 Jul-Aug;14(4):525-30. doi: 10.1016/j.brachy.2015.01.005. Epub 2015 Apr 8.
To analyze the results of exclusive brachytherapy (BT) to treat patients with penile squamous cell carcinoma confined to the glans or prepuce.
Retrospective analysis of 25 patients treated for T1-T2 penile cancer with exclusive interstitial BT between July 1989 and March 2014 at our institution.
Median followup was 9.2 years (range, 0-19). The mean patient age was 65.3 years (range, 51-80). Most patients underwent exclusive low-dose-rate BT (56%; n = 14) or pulsed-dose-rate BT (40%; n = 10). Only 1 patient received high-dose-rate BT (4%). The median prescribed dose was 60 Gy. Eight patients died during follow-up because of systemic progression (one case) and other intercurrent causes (seven cases). Two failures were recorded (one local and one regional), both at 4 months after BT. The remaining patients continued follow-up at our institution and maintained response. Two patients underwent partial phallectomy for toxicity. At the time of this report, 12 of the 25 patients are alive and free of disease. The most common late toxicities were telangiectasia, urethral stenosis, and atrophy, in 48%, 43%, and 17.4% of patients, respectively.
BT with low dose rate/pulsed dose rate provides excellent locoregional control for small (≤4 cm) T1-T2 squamous cell carcinoma of the penile glans.
分析单纯近距离放射治疗(BT)用于治疗局限于龟头或包皮的阴茎鳞状细胞癌患者的效果。
回顾性分析1989年7月至2014年3月在本机构接受单纯组织间BT治疗的25例T1-T2期阴茎癌患者。
中位随访时间为9.2年(范围0-19年)。患者平均年龄为65.3岁(范围51-80岁)。大多数患者接受单纯低剂量率BT(56%;n = 14)或脉冲剂量率BT(40%;n = 10)。仅1例患者接受高剂量率BT(4%)。中位处方剂量为60 Gy。8例患者在随访期间因全身进展(1例)和其他并发原因(7例)死亡。记录到2例治疗失败(1例局部失败和1例区域失败),均发生在BT后4个月。其余患者在本机构继续随访并维持缓解状态。2例患者因毒性反应接受了部分阴茎切除术。在本报告发布时,25例患者中有12例存活且无疾病。最常见的晚期毒性反应分别为毛细血管扩张、尿道狭窄和萎缩,发生率分别为48%、43%和17.4%。
低剂量率/脉冲剂量率BT对阴茎龟头小(≤4 cm)的T1-T2期鳞状细胞癌提供了良好的局部区域控制。