Santos Miguel, Guinot José Luis, Tortajada Maribel, Vendrell Juan Bosco, López Celia, La Rosa Alonso, Quiles Beatriz, Chust Marisa, Montaner Alba, Arribas Leo
Department of Radiation Oncology, Fundación Instituto Valenciano de Oncología (FIVO), Valencia, Spain.
Department of Otolaryngology, Fundación Instituto Valenciano de Oncología (FIVO), Valencia, Spain.
J Contemp Brachytherapy. 2022 Feb;14(1):23-28. doi: 10.5114/jcb.2022.113425. Epub 2022 Feb 8.
To analyze the results of patients treated with perioperative interstitial brachytherapy (ISBT) in tongue carcinoma (TC).
From April 2009 to May 2015, 43 squamous cell carcinoma consecutive patients diagnosed with TC were treated with limited partial glossectomy and perioperative ISBT, using high-dose-rate (HDR). Twenty- seven patients were treated by brachytherapy (BT), and sixteen received BT as a complement to subsequent external beam radiotherapy (EBRT) after results of lymph node dissection. Median age was 66 years. Distribution by stage, included 10 patients stage I, 14 stage II, 10 stage III, and 9 stage IV. Eighteen patients had negative margins, nineteen margin involvement, and in six cases, the margin was < 5 mm.
With a median follow-up of 54 months, LC at 3 and 5 years was 87% and 84%, respectively. LC was 95% at five years in patients with clear margins, and 75% with involved margins. LC in N0 patients treated with BT was 83% at 5 years, and in patients N+ with posterior EBRT treatment, LC was 86%. By tumor size, we found one local relapse in 13 cases T1, in 5 of 27 patients T2 was found, and no local relapse T3 with LC of 87%, 70%, and 100% respectively at five years. Regional control (RC) was 81% at 3 and 5 years. We found a metastasis-free survival of 91% at 3- and 5-year. Twenty-three patients have died, 11 of them due to other causes, with overall survival of 56% at three years and 53% at five years.
Combined treatment with conservative surgery and ISBT shows similar results to radical surgery or RT alone, allowing a more patient-tailored approach, with good organ function preservation and cosmetic outcomes.
分析舌癌（TC）患者围手术期组织间近距离放疗（ISBT）的治疗结果。
2009年4月至2015年5月，43例经诊断为TC的鳞状细胞癌连续患者接受了有限部分舌切除术和围手术期高剂量率（HDR）ISBT治疗。27例患者接受了近距离放疗（BT），16例在淋巴结清扫术后接受BT作为后续外照射放疗（EBRT）的补充。中位年龄为66岁。按分期分布，包括10例I期患者、14例II期患者、10例III期患者和9例IV期患者。18例患者切缘阴性，19例切缘受累，6例切缘<5mm。
中位随访54个月，3年和5年的局部控制率（LC）分别为87%和84%。切缘清晰的患者5年LC为95%，切缘受累的患者为75%。接受BT治疗的N0患者5年LC为83%，接受EBRT治疗的N+患者LC为86%。按肿瘤大小，我们发现13例T1患者中有1例局部复发，27例T2患者中有5例局部复发，但T3患者无局部复发，5年LC分别为87%、70%和100%。区域控制（RC）在3年和5年时为81%。我们发现3年和5年时无转移生存率为91%。23例患者死亡，其中11例死于其他原因，3年总生存率为56%，5年为53%。
保守手术与ISBT联合治疗显示出与单纯根治性手术或放疗相似的结果，允许采用更适合患者的方法，具有良好的器官功能保留和美容效果。
