Pohanková D, Sirák I, Kašaová L, Grepl J, Paluska P, Louda M, Holub L, Špaček J, Prošvic P, Petera J
Klin Onkol. 2019 Winter;32(1):52-57. doi: 10.14735/amko201952.
Interstitial low dose rate brachyther-apy is established organ spar-ing treatment of T1- T2 penile carcinoma. Experience with high-dose rate brachyther-apy is limited in this indication.
Twenty-six patients with early penile carcinoma were treated by high-dose rate brachyther-apy at dose 18 × 3 Gy per fraction twice daily between 2002- 2018 at the Department of Oncology and Radiother-apy, University Hospital in Hradec Kralove. Breast interstitial brachyther-apy template was used for fixation and precise geometry reconstruction of stainless hollow needles.
Median follow up was 85 months (range 7- 200 months). Acute reaction usually consisted of grade 2 mucositis that dissolved dur-ing 8 weeks after the treatment. Local recurrence occurred in 6 patients, 5 of them were successfully treated with partial amputation. One patient had a nodal recurrence successfully salvaged by lymphadenectomy. One patient developed necrosis of the glans requir-ing partial amputation. Currently, there are 24 patients alive without signs of dis-ease. One patient died of cardiac comorbidity, one died of duplicate lung cancer. Nineteen patients have a preserved penis (73%), 18 of them sexually active before treatment report satisfactory intercourse.
Hyperfractionated interstitial high-dose rate brachyther-apy with 18 × 3 Gy per fraction twice daily is a promis-ing method in selected patients with penile carcinoma and deserves further evaluation in a larger prospective study. Key words penile neoplasms - conservative treatment - brachyther-apy This work was supported by programm Progres Q40. The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study. The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers. Submitted: 8. 1. 2019 Accepted: 15. 1. 2019.
间质低剂量率近距离放射治疗是T1 - T2期阴茎癌公认的器官保留治疗方法。高剂量率近距离放射治疗在该适应证方面的经验有限。
2002年至2018年期间，在赫拉德茨克拉洛韦大学医院肿瘤与放射治疗科，对26例早期阴茎癌患者采用高剂量率近距离放射治疗，每次分割剂量为18×3 Gy，每日两次。使用乳腺间质近距离放射治疗模板固定不锈钢空心针并精确重建几何形状。
中位随访时间为85个月（范围7 - 200个月）。急性反应通常为2级黏膜炎，在治疗后8周内消退。6例患者出现局部复发，其中5例通过部分截肢成功治疗。1例患者出现淋巴结复发，通过淋巴结清扫成功挽救。1例患者发生龟头坏死，需要部分截肢。目前，有24例患者存活且无疾病迹象。1例患者死于心脏合并症，1例死于双原发肺癌。19例患者保留阴茎（73%），其中18例在治疗前有性生活，报告性交满意。
每日两次、每次分割剂量为18×3 Gy的超分割间质高剂量率近距离放射治疗，对于选定的阴茎癌患者是一种有前景的方法，值得在更大规模的前瞻性研究中进一步评估。关键词阴茎肿瘤 - 保守治疗 - 近距离放射治疗 本研究得到了Progres Q40项目的支持。作者声明他们在研究中使用的药物、产品或服务方面不存在潜在利益冲突。编辑委员会声明该手稿符合ICMJE关于生物医学论文的推荐标准。提交日期：2019年1月8日 接受日期：2019年1月15日
