Yoshida Ken, Kotsuma Tadayuki, Akiyama Hironori, Yamazaki Hideya, Takenaka Tadashi, Masui Koji, Tsujimoto Yutaka, Murakami Naoya, Uesugi Yasuo, Shimbo Taiju, Yoshikawa Nobuhiko, Yoshioka Hiroto, Nakata Mio, Arika Takumi, Takaoka Yuji, Tanaka Eiichi, Tselis Nikolaos
Department of Radiation Oncology, Osaka Medical College, Takatsuki, Osaka, Japan.
Department of Radiation Oncology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
J Contemp Brachytherapy. 2019 Dec;11(6):573-578. doi: 10.5114/jcb.2019.91225. Epub 2019 Dec 25.
Tongue edema is a potential cause of treatment target underdosage in high-dose-rate interstitial brachytherapy (HDR-ISBT) of mobile tongue cancer. To prevent such edema-associated alteration of dosimetry, we developed a special silicon device. In this report we communicate our initial experience with two mobile tongue cancer patients whom we treated using this new device.
The device consists of silicone tubes with a fixed width and scalable length depending on tongue size. These tubes are lined and fixed like a palisade, allowing the device to be used also as a template. The device is placed next to the lateral border of the tongue and on the floor of the mouth. In addition, a vinyl template can be placed on the dorsal tongue surface with both devices combined for implantation guidance. Between June and August 2012, two patients with locally confined tongue cancer were treated.
Between June and August 2012, two mobile tongue cancer patients classified as cT2N0M0 were treated with HDR-ISBT using the silicone device. They underwent ISBT as monotherapy with fractional doses of 6.0 Gy up to a total physical dose of 54.0 Gy. The D (CTV) values of both patients were 6.3 Gy and 6.6 Gy and the D (mandible) values were 3.4 Gy and 2.6 Gy, respectively. At present, both patients remain without local disease recurrence at 60 and 56 months after ISBT, respectively.
The described silicone device has the potential to prevent underdosage to the treatment target related to tongue edema. It has been shown to be safe and easy to implement.
舌水肿是活动期舌癌高剂量率组织间近距离放疗（HDR-ISBT）中治疗靶区剂量不足的潜在原因。为防止这种与水肿相关的剂量学改变，我们开发了一种特殊的硅制装置。在本报告中，我们交流了使用这种新装置治疗两名活动期舌癌患者的初步经验。
该装置由硅树脂管组成，其宽度固定，长度可根据舌头大小进行调整。这些管子像栅栏一样排列并固定，使该装置也可作为模板使用。该装置放置在舌头的外侧边缘旁边和口腔底部。此外，可将乙烯基模板放置在舌背表面，将两种装置结合起来用于植入引导。2012年6月至8月，对两名局部局限型舌癌患者进行了治疗。
2012年6月至8月，两名被归类为cT2N0M0的活动期舌癌患者接受了使用硅制装置的HDR-ISBT治疗。他们接受了ISBT单一疗法，分次剂量为6.0 Gy，总物理剂量达54.0 Gy。两名患者的D（CTV）值分别为6.3 Gy和6.6 Gy，D（下颌骨）值分别为3.4 Gy和2.6 Gy。目前，两名患者在ISBT后分别于60个月和56个月时均未出现局部疾病复发。
所述硅制装置有可能防止与舌水肿相关的治疗靶区剂量不足。已证明其安全且易于实施。
