Murakami Naoya, Yoshimoto Seiichi, Nakamura Satoshi, Uematsu Masakazu, Kashihara Tairo, Takahashi Kana, Inaba Koji, Okuma Kae, Igaki Hiroshi, Nakayama Yuko, Itami Jun
Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan.
Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan.
BJR Case Rep. 2020 Feb 12;6(1):20190059. doi: 10.1259/bjrcr.20190059. eCollection 2020 Mar.
High-dose-rate interstitial brachytherapy (HDR-ISBT) is relatively rarely applied for the head and neck cancer. However, its dose distribution is more confined than intensity modulated radiation therapy (IMRT) and can deliver higher dose while sparing surrounding normal tissues. In this case report, the effectiveness of HDR-ISBT as a boost following IMRT for post-operative recurrent oropharyngeal cancer patient was indicated. A 73-year-old male who developed local recurrence after surgery for oropharyngeal squamous cell carcinoma. Salvage IMRT up to 70 Gy concurrent with weekly cetuximab was planned. However, CT taken at 60 Gy found a residual tumor, then, boost HDR-ISBT was proposed. 1 week after 60 Gy of IMRT, HDR-ISBT, 12 Gy in 2 fractions, was delivered under local anesthesia. MRI taken 2 months after HDR-ISBT showed no residual tumor. It was demonstrated that boost HDR-ISBT following IMRT for local recurrence of oropharyngeal cancer was performed safely and showed favorable efficacy.
高剂量率组织间近距离放射治疗（HDR-ISBT）相对较少应用于头颈癌。然而，其剂量分布比调强放射治疗（IMRT）更局限，并且能够在保护周围正常组织的同时给予更高剂量。在本病例报告中，显示了HDR-ISBT作为IMRT后的强化治疗用于术后复发性口咽癌患者的有效性。一名73岁男性，口咽鳞状细胞癌术后出现局部复发。计划进行剂量达70 Gy的挽救性IMRT并联合每周使用西妥昔单抗。然而，在60 Gy时进行的CT检查发现有残留肿瘤，随后建议采用强化HDR-ISBT。在IMRT 60 Gy后1周，在局部麻醉下给予HDR-ISBT，分2次给予，每次12 Gy。HDR-ISBT后2个月进行的MRI检查显示无残留肿瘤。结果表明，IMRT后采用强化HDR-ISBT治疗口咽癌局部复发是安全的，且显示出良好的疗效。
