Radiation Oncology Department, Hospital del Mar, Parc de Salut Mar, Passeig Marítim 25, 08003, Barcelona, Spain.
Institut Hospital del Mar d'Investigacions Mèdiques Barcelona, Barcelona, Spain.
Clin Transl Oncol. 2022 Mar;24(3):578-585. doi: 10.1007/s12094-021-02718-2. Epub 2021 Oct 26.
Our center adopted high-dose-rate brachytherapy with surface applicators (plesiotherapy) in 2008, creating custom molds to treat irregular areas. This study describes the efficacy and safety outcomes after extensive follow-up in the patients.
METHODS/PATIENTS: We planned the treatment using two computed tomography (CT) scans: the first to delineate the lesion and the second after placing the thermoplastic mold. Fusing the two CT images enables planning of the target volume and pinpointing, where the catheters are in the mold.
Seventy patients received plesiotherapy, either exclusively or following excision in patients with risk factors for recurrence. Those receiving plesiotherapy alone showed a complete response rate of 95.8%, and recurrences occurred in 5.7% at a mean follow-up of 96.2 months. Chronic toxicity appeared in 26.6% of patients, but severity was limited to grade 1 or 2.
High-dose-rate brachytherapy with customized molds yields a high rate of complete response, with long-term recurrence rates in line with similar studies and an acceptable toxicity rate.
我中心自 2008 年起采用表面施源器的高剂量率近距离治疗（姑息治疗），为治疗不规则部位创建定制模具。本研究对广泛随访后的患者疗效和安全性结局进行了描述。
方法/患者：我们使用两次计算机断层扫描（CT）进行治疗计划：第一次用于描绘病变，第二次在放置热塑模具后进行。将两次 CT 图像融合可规划靶区，并确定导管在模具中的位置。
70 例患者接受了姑息治疗，这些患者或单独接受治疗，或在有复发风险因素的患者中接受姑息治疗联合切除术。单独接受姑息治疗的患者完全缓解率为 95.8%，在平均 96.2 个月的随访中，复发率为 5.7%。26.6%的患者出现慢性毒性，但严重程度限于 1 级或 2 级。
采用定制模具的高剂量率近距离治疗可获得较高的完全缓解率，长期复发率与类似研究一致，且毒性发生率可接受。
