Toya Ryo, Saito Tetsuo, Matsuyama Tomohiko, Watakabe Takahiro, Yamaguchi Kohsei, Murakami Daizo, Honda Yumi, Mizutari Sachiko, Orita Yorihisa, Oya Natsuo
Department of Radiation Oncology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
Department of Otolaryngology-Head and Neck Surgery, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
BJR Case Rep. 2020 Jun 12;6(4):20190132. doi: 10.1259/bjrcr.20190132. eCollection 2020 Dec 1.
Surgery with or without post-operative radiotherapy is the mainstay treatment for salivary gland carcinoma (SGC); however, palliative radiotherapy or supportive observation is considered for elderly patients. An 87-year-old female who was diagnosed with SGC in the left parotid gland, with a clinical stage T4aN2bM0 Stage IVA, underwent the Radiation Therapy Oncology Group 8502 "QUAD shot" regimen (14.8 Gy/4 fractions, twice-daily treatment with a 6 h interval, on 2 consecutive days), which were repeated every 4 weeks 3 times using volumetric modulated arc therapy. During and after the treatment, she experienced no acute toxicity but had Grade 1 xerostomia. At 4 months after completion of the treatment, [F]-fluoro-2-deoxy-D-glucose positron emission tomography/CT revealed a complete metabolic response to the treatment. She is still alive without any evidence of recurrence 9 months after completion of the treatment. The Radiation Therapy Oncology Group 8502 "QUAD shot" regimen using VMAT may be an effective palliative treatment for SGC with minimal toxicity.
手术联合或不联合术后放疗是涎腺癌（SGC）的主要治疗方法；然而，对于老年患者，考虑采用姑息性放疗或支持性观察。一名87岁女性被诊断为左腮腺SGC，临床分期为T4aN2bM0 ⅣA期，接受了放射治疗肿瘤学组8502“四联注射”方案（14.8 Gy/4次分割，每天两次，间隔6小时，连续2天），每4周重复3次，采用容积调强弧形放疗。治疗期间及治疗后，她未出现急性毒性反应，但有1级口干。治疗完成4个月后，[F] - 氟 - 2 - 脱氧 - D - 葡萄糖正电子发射断层扫描/计算机断层扫描显示对治疗有完全代谢反应。治疗完成9个月后，她仍然存活，没有任何复发迹象。采用容积调强弧形放疗的放射治疗肿瘤学组8502“四联注射”方案可能是一种对SGC有效的姑息性治疗方法，毒性最小。
