Mut Alejandro, Guinot José Luis, Arribas Leoncio, Díez-Presa Lorena, Tortajada María Isabel, Santos Miguel Ángel, Samper Josefa, Santamaría Paula, Vendrell Juan Bosco
Servicio de Oncología Radioterápica, Fundación Instituto Valenciano de Oncología (IVO), Valencia, España.
Servicio de Oncología Radioterápica, Fundación Instituto Valenciano de Oncología (IVO), Valencia, España.
Acta Otorrinolaringol Esp. 2016 Sep-Oct;67(5):282-7. doi: 10.1016/j.otorri.2015.12.003. Epub 2016 Apr 7.
To analyze the results obtained after treatment of early stage (T1-T2) squamous cell carcinoma of the lip with high dose rate brachytherapy and evaluate the efficacy of this treatment in both local and regional control.
Retrospective analysis of the treatments performed at our department from March 1999 to March 2013 with high dose rate brachytherapy with rigid needles. We included 68 patients, 63 men and 5 women; 37 patients (54.4%) presented a T1 tumour, less than or equal to 2cm, while the other 31 (45.6%) were classified as T2. Median total dose was 45Gy, with a median dose per fraction of 5Gy x 9 fractions twice a day for 5 days.
With a mean follow-up of 56.4 months, local control was 96.9%. Stratifying by tumour size, local control of T1 cases was 100%, while T2 achieved 93.2% (2 local recurrences). Regional control at 5 years was 93.8% for T1, and 80.8% for T2. In 11 cases with elective cervical treatment, no regional failure happened. As for toxicity, no patient presented soft tissue, or bone, necrosis. All patients achieved good or excellent cosmetic and functional results.
High dose rate brachytherapy allows effective, safe treatments for squamous cell carcinoma of the lip, with good aesthetic and functional results. It can be considered a valid alternative for surgery in early stage tumours.
分析高剂量率近距离放射治疗早期（T1 - T2）唇鳞状细胞癌后的结果，并评估该治疗在局部和区域控制方面的疗效。
回顾性分析1999年3月至2013年3月在我科采用刚性针进行高剂量率近距离放射治疗的病例。我们纳入了68例患者，其中63例男性，5例女性；37例患者（54.4%）肿瘤为T1期，直径小于或等于2cm，另外31例（45.6%）为T2期。中位总剂量为45Gy，中位分次剂量为5Gy，每天两次，共9次，持续5天。
平均随访56.4个月，局部控制率为96.9%。按肿瘤大小分层，T1期病例的局部控制率为100%，而T2期为93.2%（2例局部复发）。T1期5年区域控制率为93.8%，T2期为80.8%。在11例接受选择性颈部治疗的病例中，未发生区域失败。至于毒性反应，没有患者出现软组织或骨坏死。所有患者均获得了良好或优异的美容和功能效果。
高剂量率近距离放射治疗可为唇鳞状细胞癌提供有效、安全的治疗，具有良好的美学和功能效果。对于早期肿瘤，它可被视为手术的有效替代方案。
