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高剂量率近距离放射治疗(腔内放疗)治疗头颈部原发和复发性恶性肿瘤。

HDR interventional radiotherapy (brachytherapy) in the treatment of primary and recurrent head and neck malignancies.

机构信息

Universitá Cattolica del Sacro Cuore, Istituto di Otorinolaringoiatria, Roma, Italia.

ENT Division, Azienda Ospedaliero Universitaria, Sassari, Italia.

出版信息

Head Neck. 2019 Jun;41(6):1667-1675. doi: 10.1002/hed.25646. Epub 2019 Jan 30.

Abstract

BACKGROUND

Interventional radiotherapy (brachytherapy; IRT) reemerged in the last decades as a potentially useful tool in head and neck oncology after a set of clear technical improvements were developed.

METHODS

Sixty-one high dose ratio (HDR) IRT treatments were recommended and performed on 58 patients. We classified the cases into four relatively homogeneous groups based on the clinical needs that led to the recommended IRT. Also, we separately evaluated primary and recurrent cases.

RESULTS

Disease-specific survival was significantly different among the four treatment groups. The group with the best prognosis was the cohort treated locally by exclusive interstitial IRT for resectable midface malignancies (2-year relapse-free survival = 82%, disease-specific survival = 89%).

CONCLUSION

HDR IRT is a valuable tool in well-defined clinical situations and, in particular, in recurrences. In midface malignancies, it could become the preferred primary treatment.

摘要

背景

在一系列明确的技术改进之后,介入放射治疗(近距离放射治疗;IRT)作为一种潜在的有用工具,在头颈部肿瘤学领域重新出现。

方法

为 58 名患者推荐并实施了 61 例高剂量比(HDR)IRT 治疗。我们根据导致推荐 IRT 的临床需求,将病例分为四个相对同质的组。此外,我们还分别评估了原发性和复发性病例。

结果

四种治疗组之间疾病特异性生存率有显著差异。预后最好的是单独接受可切除中面部恶性肿瘤间质内 IRT 局部治疗的队列(2 年无复发生存率=82%,疾病特异性生存率=89%)。

结论

HDR IRT 是在明确的临床情况下的一种有价值的工具,特别是在复发的情况下。在中面部恶性肿瘤中,它可能成为首选的主要治疗方法。

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