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使用图像引导的高剂量率组织间近距离放射治疗成功挽救治疗上颌窦癌难治性复发

Successful salvage treatment of refractory recurrence of maxillary sinus carcinoma using image-guided high-dose-rate interstitial brachytherapy.

作者信息

Zhang Yin, Wu Ning, Zhao Zhipeng, Chen Qianqian, Cheng Guanghui

机构信息

Department of Radiation Oncology, China-Japan Union Hospital of Jilin University, Changchun, China.

出版信息

J Contemp Brachytherapy. 2018 Apr;10(2):162-168. doi: 10.5114/jcb.2018.75601. Epub 2018 Apr 30.

DOI:10.5114/jcb.2018.75601
PMID:29789765
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5961531/
Abstract

This case report illustrates a treatment effect of image-guided high-dose-rate (HDR) interstitial brachytherapy for refractory recurrence of maxillary sinus carcinoma. A 61-year-old male was previously admitted to another hospital and received surgery because of left maxillary sinus squamous cell carcinoma (SCC) 6 years ago. Tumor regrowth was noted 2 years after the initial radical surgery. The patient accepted local excision again for the recurrence, followed by external beam radiotherapy. Despite salvage treatment with surgery and external irradiation, the lesion expanded as 4.8 × 4.4 × 4.0 cm. Because the patient refused palliative resection, we recommended technique of image-guided HDR interstitial brachytherapy. The total doses of 42 Gy in 12 fractions were delivered to the whole recurrent tumor. Removal of the recurrent tumor was securely achieved by HDR interstitial brachytherapy, guided with ultrasound. The refractory tumor in the patient healed uneventfully after HDR interstitial brachytherapy without recurrence during 8 months of follow-up. This case is remarkable because the patient experienced complete remission by a safe and practicable method with image-guided HDR interstitial brachytherapy.

摘要

本病例报告阐述了影像引导下高剂量率（HDR）组织间近距离放射治疗上颌窦癌难治性复发的治疗效果。一名61岁男性6年前因左上颌窦鳞状细胞癌（SCC）入住另一家医院并接受了手术。初次根治性手术后2年发现肿瘤复发。患者因复发再次接受局部切除，随后接受了外照射放疗。尽管采取了手术和外照射挽救治疗，但病变仍扩大至4.8×4.4×4.0 cm。由于患者拒绝姑息性切除，我们建议采用影像引导下HDR组织间近距离放射治疗技术。将12次分割的42 Gy总剂量给予整个复发性肿瘤。在超声引导下，通过HDR组织间近距离放射治疗成功切除了复发性肿瘤。患者的难治性肿瘤在HDR组织间近距离放射治疗后顺利愈合，随访8个月无复发。该病例引人注目，因为患者通过影像引导下HDR组织间近距离放射治疗这种安全可行的方法实现了完全缓解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5d4/5961531/81c9d9817f31/JCB-10-32739-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5d4/5961531/6415521de64d/JCB-10-32739-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5d4/5961531/05437e189cab/JCB-10-32739-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5d4/5961531/9efd26ce1d48/JCB-10-32739-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5d4/5961531/81c9d9817f31/JCB-10-32739-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5d4/5961531/6415521de64d/JCB-10-32739-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5d4/5961531/05437e189cab/JCB-10-32739-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5d4/5961531/9efd26ce1d48/JCB-10-32739-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c5d4/5961531/81c9d9817f31/JCB-10-32739-g004.jpg

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