Cisek Paweł, Kieszko Dariusz, Bilski Mateusz, Dębicki Radomir, Grywalska Ewelina, Hrynkiewicz Rafał, Bębnowska Dominika, Kordzińska-Cisek Izabela, Rolińska Agnieszka, Niedźwiedzka-Rystwej Paulina, Grzybowska-Szatkowska Ludmiła
Department of Brachytherapy, St. John's Cancer Center, 20-090 Lublin, Poland.
Department of Radiotherapy, Medical University of Lublin, 20-093 Lublin, Poland.
Cancers (Basel). 2021 Mar 20;13(6):1425. doi: 10.3390/cancers13061425.
Eyelid tumors are rare skin cancers, the most common of which is basal cell carcinoma characterized primarily by local growth. In addition to surgery, radiotherapy is among the basic methods of treatment. External beam radiotherapy is associated with the risk of complications within ocular structures, especially the lens. In the case of interstitial brachytherapy, it is possible to administer a high dose to the clinical target volume (CTV), while reducing it in the most sensitive structures.
This paper presents the results of an analysis of 28 patients treated with interstitial high dose rate (HDR) brachytherapy for skin cancers of the upper and lower eyelid; medial and lateral canthus; and the cheek, nose and temples with the infiltration of ocular structures. The patients were treated according to two irradiation schedules: 49 Gy in 14 fractions of 3.5 Gy twice a day for 7 days of treatment, and 45 Gy in 5 Gy fractions twice a day for 5 days. The mean follow-up was 22 months (3-49 months).
two patients (6%) had a relapse: a local recurrence within the irradiated area in one of them, and metastases to lymph nodes in the other. The most common early complication was conjunctivitis (74%), and the most common late complication was dry eye syndrome (59%).
Interstitial HDR brachytherapy for skin cancers of the upper and lower eyelid; medial and lateral cants; and the cheek, nose and temples with infiltration of ocular structures is a highly effective, short and relatively low burden type of treatment.
眼睑肿瘤是罕见的皮肤癌，其中最常见的是主要以局部生长为特征的基底细胞癌。除手术外，放射治疗是基本的治疗方法之一。外照射放疗存在眼内结构尤其是晶状体发生并发症的风险。对于组织间近距离放疗而言，有可能在向临床靶区（CTV）给予高剂量的同时，降低对最敏感结构的剂量。
本文介绍了对28例因上下眼睑、内外眦、脸颊、鼻子和太阳穴皮肤癌伴眼内结构浸润而接受组织间高剂量率（HDR）近距离放疗患者的分析结果。这些患者按照两种照射方案进行治疗：一种是在7天的治疗时间内，每天两次，每次3.5 Gy，分14次给予49 Gy；另一种是在5天的治疗时间内，每天两次，每次5 Gy，分5次给予45 Gy。平均随访时间为22个月（3 - 49个月）。
2例患者（6%）出现复发：其中1例在照射区域内局部复发，另1例发生淋巴结转移。最常见的早期并发症是结膜炎（74%），最常见的晚期并发症是干眼综合征（59%）。
对于上下眼睑、内外眦、脸颊、鼻子和太阳穴伴眼内结构浸润的皮肤癌，组织间高剂量率近距离放疗是一种高效、疗程短且负担相对较低的治疗方式。
