早期鼻鳞状细胞癌间质近距离放射治疗后的临床结果。

Clinical outcomes after interstitial brachytherapy for early-stage nasal squamous cell carcinoma.

作者信息

Bacorro Warren, Escande Alexandre, Temam Stéphane, Dumas Isabelle, Routier Emilie, Gensse Marie-Catherine, Blanchard Pierre, Janot François, Mateus Christine, Tao Yungan, Robert Caroline, Deutsch Eric, Haie-Meder Christine, Chargari Cyrus

机构信息

Brachytherapy Unit, Gustave Roussy, Villejuif, France; Department of Radiotherapy, Gustave Roussy, Villejuif, France; Department of Radiotherapy, Benavides Cancer Institute, University of Santo Tomas, Manila, Philippines.

Brachytherapy Unit, Gustave Roussy, Villejuif, France; Department of Radiotherapy, Gustave Roussy, Villejuif, France; Department of Radiotherapy, Oscar Lambret Cancer Center, Lille, France.

出版信息

Brachytherapy. 2017 Sep-Oct;16(5):1021-1027. doi: 10.1016/j.brachy.2017.06.009. Epub 2017 Jul 23.

DOI:10.1016/j.brachy.2017.06.009

PMID:28743612

Abstract

PURPOSE

Radiotherapy of nasal carcinomas results in cure rates comparable to surgery, with anatomic preservation and good cosmesis. Brachytherapy (BT) overcomes difficulties with dosimetric coverage and affords a localized and highly conformal irradiation. We report our experience of BT for early-stage nasal squamous cell carcinomas (SCCs).

METHODS AND MATERIALS

Clinical data, BT parameters, and outcome of consecutive patients treated by interstitial BT in our institute between December 1982 and April 2015 for a localized nasal SCC were examined. A total of 34 patients with newly diagnosed T1-2N0-1 nasal skin (n = 22) or nasal cavity (n = 12) SCC were identified. Implantation and dosimetry were done according to the Paris system rules. Low-dose-rate (n = 30) or pulsed-dose-rate (n = 4) techniques were used. Median dose was 70 Gy (64-75 Gy). Sites of tumor recurrence, toxicity rates, and cosmesis outcome were examined.

RESULTS

Median followup time was 89 months. All patients achieved complete response. Five patients experienced local failure, with a median interval of 9 months (range, 5-12 months). Grade 3 acute reactions were reported in 2 patients (6%). Most delayed complications were mild to moderate, and good or fair cosmesis was achieved in 97%. Estimated local failure-free survival and disease-free survival rates at 5 year were 85% (95% CI = 68-94%) and 76% (95% CI = 58-88%), respectively.

CONCLUSIONS

Interstitial BT is effective for selected nasal SCCs, with durable local control, acceptable toxicity, and good cosmesis.

摘要

目的

鼻咽癌的放射治疗治愈率与手术相当，可保留解剖结构且美容效果良好。近距离放射治疗（BT）克服了剂量覆盖方面的困难，可提供局部且高度适形的照射。我们报告了我们对早期鼻鳞状细胞癌（SCC）进行BT治疗的经验。

方法和材料

对1982年12月至2015年4月间在我们研究所接受间质BT治疗局限性鼻SCC的连续患者的临床数据、BT参数和结果进行了检查。共确定了34例新诊断为T1-2N0-1鼻皮肤（n = 22）或鼻腔（n = 12）SCC的患者。植入和剂量测定按照巴黎系统规则进行。采用低剂量率（n = 30）或脉冲剂量率（n = 4）技术。中位剂量为70 Gy（64-75 Gy）。检查了肿瘤复发部位、毒性率和美容效果。

结果

中位随访时间为89个月。所有患者均达到完全缓解。5例患者出现局部失败，中位间隔时间为9个月（范围5-12个月）。2例患者（6%）报告有3级急性反应。大多数迟发性并发症为轻至中度，97%的患者美容效果良好或尚可。5年时估计的局部无失败生存率和无病生存率分别为85%（95%CI = 68-94%）和76%（95%CI = 58-88%）。