El Ayachy Radouane, Sun Roger, Ka Kanta, Laville Adrien, Duhamel Anne-Sophie, Tailleur Anne, Dumas Isabelle, Bockel Sophie, Espenel Sophie, Blanchard Pierre, Tao Yungan, Temam Stéphane, Moya-Plana Antoine, Haie-Meder Christine, Chargari Cyrus
Radiation Oncology Department, Gustave Roussy Cancer Campus, Université Paris-Saclay, 114 rue Edouard Vaillant, 94800 Villejuif, France.
Head and Neck Surgery Department, Gustave Roussy, 94800 Villejuif, France.
Cancers (Basel). 2021 Mar 19;13(6):1387. doi: 10.3390/cancers13061387.
Lip carcinoma represents one of the most common types of head and neck cancer. Brachytherapy is a highly effective therapeutic option for all stages of lip cancers. We report our experience of pulsed dose rate brachytherapy (PDR) as treatment of lip carcinoma.
this retrospective single center study included all consecutive patients treated for a lip PDR brachytherapy in our institution from 2010 to 2019. The toxicities and outcomes of the patients were reported, and a retrospective quality of life assessment was conducted by phone interviews (FACT H&N).
From October 2010 to December 2019, 38 patients were treated in our institution for a lip carcinoma by PDR brachytherapy. The median age was 73, and the majority of patients presented T1-T2 tumors (79%). The median total dose was 70.14 Gy (range: 60-85 Gy). With a mean follow-up of 35.4 months, two patients (5.6%) presented local failure, and seven patients (19%) had lymph node progression. The Kaplan-Meier estimated probability of local failure was 7.2% (95% CI: 0.84-1) at two and four years. All patients encountered radiomucitis grade II or higher. The rate of late toxicities was low: three patients (8.3%) had grade II fibrosis, and one patient had grade II chronic pain. All patients would highly recommend the treatment. The median FACT H&N total score was 127 out of 148, and the median FACT H&N Trial Outcome Index was 84.
This study confirms that an excellent local control rate is achieved with PDR brachytherapy as treatment of lip carcinoma, with very limited late side effects and satisfactory functional outcomes. A multimodal approach should help to improve regional control.
唇癌是头颈癌最常见的类型之一。近距离放射治疗是唇癌各阶段的一种高效治疗选择。我们报告了脉冲剂量率近距离放射治疗（PDR）治疗唇癌的经验。
这项回顾性单中心研究纳入了2010年至2019年在我们机构接受唇PDR近距离放射治疗的所有连续患者。报告了患者的毒性反应和治疗结果，并通过电话访谈（FACT H&N）进行了回顾性生活质量评估。
2010年10月至2019年12月，38例患者在我们机构接受了PDR近距离放射治疗唇癌。中位年龄为73岁，大多数患者表现为T1-T2期肿瘤（79%）。中位总剂量为70.14 Gy（范围：60-85 Gy）。平均随访35.4个月，2例患者（5.6%）出现局部复发，7例患者（19%）有淋巴结进展。两年和四年时，Kaplan-Meier估计的局部复发概率为7.2%（95%CI：0.84-1）。所有患者均出现II级或更高等级的放射性粘膜炎。晚期毒性发生率较低：3例患者（8.3%）出现II级纤维化，1例患者出现II级慢性疼痛。所有患者都强烈推荐该治疗方法。FACT H&N总评分中位数为148分中的127分，FACT H&N试验结果指数中位数为84分。
本研究证实，PDR近距离放射治疗唇癌可实现出色的局部控制率，晚期副作用非常有限，功能结果令人满意。多模式方法应有助于改善区域控制。
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