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复发性头颈部癌采用高剂量率近距离放射治疗再照射:一项多机构研究。

Reirradiation for recurrent head and neck carcinoma using high-dose-rate brachytherapy: A multi-institutional study.

机构信息

Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.

出版信息

Brachytherapy. 2022 May-Jun;21(3):341-346. doi: 10.1016/j.brachy.2021.12.011. Epub 2022 Mar 18.

Abstract

AIM

This study presents multi-institutional individual data of reirradiation (ReRT) for head and neck cancer using brachytherapy (ReRT-BT) collected by national surveillance in Japan.

METHODS AND MATERIALS

We distributed an e-mail-based questionnaire to 153 institutions equipped with high-dose-rate (HDR) brachytherapy facilities and received responses from 76 institutions (49.7%). Of these 76 institutions, only four (5.2%) performed ReRT-BT for head and neck cancers, and three provided individual patient's data.

RESULTS

Six ReRT-BT cases of patients with recurrent head and neck cancer, treated with HDR brachytherapy in seven ReRT sessions, were identified from three institutions. Three patients (two cases of lips and one case of gingiva) who underwent curative-intent treatment achieved complete response at the treated area. Three patients who received palliative treatment (one case of tongue and two cases of maxillary sinus) had sustained tumor growth at the treated site, but with improvement in symptoms. No grade ≥3 toxicity was found after HDR ReRT-BT.

CONCLUSIONS

ReRT-BT for head and neck cancer using HDR brachytherapy is a safe and useful approach to treat recurrent cancer after initial radiotherapy with curative and palliative intent. However, the scarce availability of ReRT-BT is a barrier to the wider utility of this effective procedure.

摘要

目的

本研究通过日本全国监测收集了使用近距离放射治疗(ReRT-BT)进行头颈部癌症再放疗(ReRT)的多机构个体数据。

方法和材料

我们向 153 个配备高剂量率(HDR)近距离放射治疗设备的机构发送了基于电子邮件的问卷,并收到了 76 个机构(49.7%)的回复。在这 76 个机构中,只有 4 个(5.2%)对头颈部癌症进行了 ReRT-BT,其中 3 个提供了个体患者的数据。

结果

从 3 个机构中确定了 6 例复发性头颈部癌症患者的 HDR 近距离放射治疗的 7 次 ReRT-BT 治疗案例。3 名患者(2 例唇部和 1 例牙龈)接受了根治性治疗,在治疗区域完全缓解。3 名接受姑息治疗(1 例舌部和 2 例上颌窦)的患者在治疗部位肿瘤持续生长,但症状得到改善。HDR ReRT-BT 后未发现≥3 级毒性。

结论

使用 HDR 近距离放射治疗对头颈部癌症进行 ReRT-BT 是一种安全且有用的方法,可用于治疗初始放疗后有根治和姑息意图的复发性癌症。然而,ReRT-BT 的可用性有限,这是限制该有效治疗方法广泛应用的一个障碍。

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