Yan Huzheng, Xiang Zhanwang, Zhong Zhihui, Mo Zhiqiang, Zhang Tao, Chen Guanyu, Zhang Fujun, Gao Fei
Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China..
Transl Oncol. 2017 Feb;10(1):90-98. doi: 10.1016/j.tranon.2016.11.007. Epub 2016 Dec 16.
We aimed to evaluate the feasibility and clinical effectiveness of CT-guided I brachytherapy for distant oral and maxillofacial metastases.
We retrospectively analyzed 65 patients with 84 distant oral and maxillofacial metastases. Thirty-one patients with 38 lesions received I brachytherapy (group A) and 34 with 46 lesions received external beam radiotherapy (EBRT; group B).
Median follow-up time was 16 months. The 3-, 6-, 12-, 18-, and 24-month local control rates for group A were 83.9%, 75.9%, 66.7%, 38.4%, and 25.0%, respectively; for group B they were 76.5%, 62.5%, 43.8%, 25.0%, and 0.0%, respectively (P<.05); the median local tumor progression-free survival times were 14 and 9 months, respectively. Group A had a better local tumor progression-free survival (LTPFS) relative to group B (P<.001; HR, 6.961 [95%CI, 2.109, 9.356]). Cox proportional hazards regression analysis indicated that I brachytherapy, tumor size, and primary pathological type were the independent factors affecting LTPFS. Additionally, I brachytherapy showed better performance in relieving patient clinical symptoms relative to EBRT (P<.05). Group A also had fewer complications than group B, especially regarding grade 3/4 complications according to Radiation Therapy Oncology Group grading criteria. Mean overall survival times in groups A and B were 17.1 and 14.8 months, respectively.
CT-guided I brachytherapy is feasible and safe for distant oral and maxillofacial metastases; it achieved a better local control rate, longer LTPFS and fewer complications without compromising overall survival compared with EBRT.
我们旨在评估CT引导下碘-125粒子近距离放射治疗口腔颌面部远处转移瘤的可行性及临床疗效。
我们回顾性分析了65例患有84处口腔颌面部远处转移瘤的患者。31例患有38处病灶的患者接受了碘-125粒子近距离放射治疗（A组），34例患有46处病灶的患者接受了外照射放疗（EBRT；B组）。
中位随访时间为16个月。A组3个月、6个月、12个月、18个月和24个月的局部控制率分别为83.9%、75.9%、66.7%、38.4%和25.0%；B组分别为76.5%、62.5%、43.8%、25.0%和0.0%（P<0.05）；中位局部肿瘤无进展生存时间分别为14个月和9个月。相对于B组，A组具有更好的局部肿瘤无进展生存（LTPFS）（P<0.001；风险比，6.961[95%置信区间，2.109，9.356]）。Cox比例风险回归分析表明，碘-125粒子近距离放射治疗、肿瘤大小和原发病理类型是影响LTPFS的独立因素。此外，相对于EBRT，碘-125粒子近距离放射治疗在缓解患者临床症状方面表现更佳（P<0.05）。A组的并发症也比B组少，尤其是根据放射治疗肿瘤学组分级标准的3/4级并发症。A组和B组的平均总生存时间分别为17.1个月和14.8个月。
CT引导下碘-125粒子近距离放射治疗口腔颌面部远处转移瘤是可行且安全的；与EBRT相比，它实现了更好的局部控制率、更长的LTPFS且并发症更少，同时不影响总生存。
