Tuček Luboš, Vošmik Milan, Petera Jiří
Department of Stomatology, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic.
Department of Oncology and Radiotherapy, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Charles University, 500 05 Hradec Králové, Czech Republic.
Cancers (Basel). 2022 Jan 3;14(1):222. doi: 10.3390/cancers14010222.
Brachytherapy (BT) involves the direct application of radioactive sources to the tumour. This technique is characterised by a steep dose gradient, the delivery of high-dose radiation to the target volume centre, and the sparing of surrounding healthy tissues. Low-dose-rate (LDR) BT and manual afterloading played an important role in the treatment of early-stage oral cancer, with treatment outcomes that were comparable to surgery. Interest in BT as a primary treatment for oral cancer has declined in recent years due to the emergence of better surgical techniques, the switch from LDR BT to high-dose-rate (HDR) BT (which has a higher risk of complications), and to advances in external beam radiotherapy (EBRT). At present, the main indications for BT are in the postoperative setting due to the superior dose conformity and better quality of life offered by BT versus EBRT. Postoperative BT can be administered as monotherapy in early-stage (T1N0) cancers and in combination with elective neck dissection or EBRT to treat larger or deeper tumours. BT yields excellent results for lip carcinoma in older patients and in tumours with unfavourable localisations. BT is an effective salvage therapy for local recurrences in previously-irradiated areas. Despite its many advantages, brachytherapy is a complex treatment requiring meticulous technique and close cooperation between the radiation oncologist, physicist, and surgeon.
近距离放射治疗（BT）涉及将放射源直接应用于肿瘤。该技术的特点是剂量梯度陡峭，向靶体积中心输送高剂量辐射，并 sparing 周围健康组织。低剂量率（LDR）BT 和手动后装在早期口腔癌的治疗中发挥了重要作用，其治疗结果与手术相当。近年来，由于更好的手术技术的出现、从 LDR BT 向高剂量率（HDR）BT 的转变（后者并发症风险更高）以及外照射放疗（EBRT）的进展，对 BT 作为口腔癌主要治疗方法的兴趣有所下降。目前，BT 的主要适应症是在术后环境中，因为与 EBRT 相比，BT 具有更好的剂量适形性和更高的生活质量。术后 BT 可作为早期（T1N0）癌症的单一疗法，也可与选择性颈部清扫术或 EBRT 联合使用，以治疗更大或更深的肿瘤。BT 对老年患者的唇癌和定位不利的肿瘤产生优异的结果。BT 是先前照射区域局部复发的有效挽救疗法。尽管近距离放射治疗有许多优点，但它是一种复杂的治疗方法，需要放射肿瘤学家、物理学家和外科医生之间精心的技术和密切的合作。 （注：“sparing”此处可能有误，推测可能是“sparing of”，意为“ sparing周围健康组织”，直译为“ sparing周围健康组织”，不太符合语境习惯，推测此处可能是想表达“保护周围健康组织”之类的意思，但按要求未作修改。）
