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阴茎癌表面敷贴器高剂量率近距离放射治疗

High-dose-rate brachytherapy with surface applicator in penile cancer.

作者信息

Saldi Simonetta, Zucchetti Claudio, Fulcheri Christian Paolo Luca, Saccia Stefano, Alì Emanuele, Marani Simona, Ingrosso Gianluca, Aristei Cynthia

机构信息

Section of Radiation Oncology, Perugia General Hospital, Perugia, Italy.

Medical Physics, Perugia General Hospital, Perugia, Italy.

出版信息

Brachytherapy. 2021 Jul-Aug;20(4):835-841. doi: 10.1016/j.brachy.2021.03.015. Epub 2021 May 13.

Abstract

PURPOSE

An alternative to surgery for penile cancer is radiation therapy which is administered with external beam techniques and/or brachytherapy (BT) either interstitial or using a surface applicator. Here we report our experience in penile cancer patients treated with high-dose-rate (HDR)-BT with the surface technique, analyzing dosimetric parameters and clinical outcomes.

METHODS AND MATERIALS

Between June 2016 and December 2019, 7 patients with squamous cell carcinoma of the penis received HDR-BT by means of customized applicators that were constructed using a 3D printer or thermoplastic mask. The total dose was 57 Gy in 19 fractions.

RESULTS

Median clinical target volume percentage receiving 95%, 125%, and 150% of the prescribed dose were 93.1% (range 92.2-98.5), 12% (range 7.4-32.2), and 0.24% (range 0-10.8), respectively. Median urethral volumes receiving 90% and 115% of the prescribed dose were 40.2% (range 21.0-83.8) and 0% (range 0-1), respectively. All patients achieved complete remission. No patient developed G3 or G4 acute or late toxicities. No patient experienced urethral stenosis.

CONCLUSIONS

Surface HDR-BT in penile cancer is feasible and is associated with a high tolerance profile and good outcomes.

摘要

目的

阴茎癌手术的替代治疗方法是放射治疗,可采用外照射技术和/或近距离放射治疗(BT),包括组织间照射或使用表面施源器。在此,我们报告采用表面技术进行高剂量率(HDR)-BT治疗阴茎癌患者的经验,分析剂量学参数和临床结果。

方法和材料

2016年6月至2019年12月期间,7例阴茎鳞状细胞癌患者通过使用3D打印机或热塑性面罩定制的施源器接受了HDR-BT治疗。总剂量为57 Gy,分19次给予。

结果

接受处方剂量95%、125%和150%的临床靶区体积中位数分别为93.1%(范围92.2 - 98.5)、12%(范围7.4 - 32.2)和0.24%(范围0 - 10.8)。接受处方剂量90%和115%的尿道体积中位数分别为40.2%(范围21.0 - 83.8)和0%(范围0 - 1)。所有患者均实现完全缓解。无患者发生3级或4级急性或晚期毒性反应。无患者出现尿道狭窄。

结论

阴茎癌表面HDR-BT是可行的,且耐受性良好,效果佳。

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