Ayerra Arrate Querejeta, Mena Estefanía Palacios, Fabregas Joan Pera, Miguelez Cristina Gutiérrez, Guedea Ferran
Department of Radiation Oncology, Hospital Donostia, San Sebastián, Spain.
Department of Radiation Oncology, Hospital de León, León, Spain.
J Contemp Brachytherapy. 2010 Mar;2(1):9-13. doi: 10.5114/jcb.2010.13717. Epub 2010 Apr 1.
Lip cancer can be treated by surgery, external radiotherapy, and/or brachytherapy (BT). In recent years, BT has become increasingly favored for this type of cancer. The aim of the present study was to analyze local control and survival of patients treated at our institution between July 1989 and June 2008.
We performed a retrospective study of 121 patients (109 males and 12 females) who underwent lip cancer brachytherapy from July 1989 to June 2008. Median age was 67 years and median follow-up was 31.8 months (range 20-188 months). Out of 121 patients, 100 (82.6%) were treated with low dose rate (LDR) BT while the remaining 21 patients (17.4%) received high dose rate (HDR) BT.
The most common cell type was squamous cell carcinoma (115 cases; 95%) and most tumors were located on the lower lip (107 patients; 88.4%). Most cases were either stage T1 (62 patients; 51.2%), or T2 (44 cases; 36.4%). After 15 years of follow-up, overall survival was 89.5%, cause-specific survival 97.8%, and disease-free survival 86.6%. Local, regional, and distant control at 15 years were 90%, 92%, and 98.8%, respectively. Grade 3 mucosal toxicity was observed in 23% of patients treated with LDR compared to 33% of HDR patients, and grade 4 mucosal toxicity in 9% versus 0% in the HDR group.
Our findings confirm that brachytherapy is an effective treatment for lip cancer. The results from our series are in line with those published elsewhere. Based on our limited data, HDR appears to be equally as good as LDR, although this needs to be confirmed by further studies.
唇癌可通过手术、外照射放疗和/或近距离放射治疗（BT）进行治疗。近年来，BT越来越受青睐用于此类癌症。本研究的目的是分析1989年7月至2008年6月在我们机构接受治疗的患者的局部控制情况和生存率。
我们对1989年7月至2008年6月接受唇癌近距离放射治疗的121例患者（109例男性和12例女性）进行了回顾性研究。中位年龄为67岁，中位随访时间为31.8个月（范围20 - 188个月）。在121例患者中，100例（82.6%）接受了低剂量率（LDR）BT治疗，其余21例患者（17.4%）接受了高剂量率（HDR）BT治疗。
最常见的细胞类型是鳞状细胞癌（115例；95%），大多数肿瘤位于下唇（107例患者；88.4%）。大多数病例为T1期（62例患者；51.2%）或T2期（44例；36.4%）。随访15年后，总生存率为89.5%，病因特异性生存率为97.8%，无病生存率为86.6%。15年时的局部、区域和远处控制率分别为90%、92%和98.8%。接受LDR治疗的患者中有23%观察到3级黏膜毒性，而接受HDR治疗的患者中这一比例为33%；4级黏膜毒性在LDR组为9%，在HDR组为0%。
我们的研究结果证实近距离放射治疗是唇癌的有效治疗方法。我们系列研究的结果与其他地方发表的结果一致。基于我们有限的数据，HDR似乎与LDR一样好，尽管这需要进一步研究来证实。
