Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Japan.
Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical and Pharmaceutical University, Japan; Kansai BNCT Medical Center, Osaka Medical and Pharmaceutical University, Japan.
Appl Radiat Isot. 2022 Nov;189:110420. doi: 10.1016/j.apradiso.2022.110420. Epub 2022 Aug 18.
Salvage surgery after radiation therapy is known to be associated with a high incidence of postoperative complications. We describe a case of a successful salvage surgery after BNCT. In our patient with head and neck carcinoma, cervical lymph node recurrence with adhesion to a large vessel occurred after conventional radiotherapy. This lesion responded well to BNCT. Salvage surgery was subsequently performed to remove the residual tumor. Histopathologically, the isolated tissue contained tumor cells in its center and the surrounding tissue showed severe fibrosis. However, the tissue outside of the irradiation area had almost no fibrosis. BNCT may facilitate salvage surgery after radiotherapy because it causes less injury to the surrounding tissue than conventional radiotherapy. Our experience suggests that BNCT may be a feasible preoperative treatment in patients with inoperable lesions or in those who strongly desire preservation of function.
放射治疗后进行挽救性手术已知与术后并发症的高发率相关。我们描述了一例硼中子俘获治疗（BNCT）后成功进行挽救性手术的病例。在我们的头颈部癌患者中，常规放射治疗后发生了颈部淋巴结复发并与大血管粘连。该病变对 BNCT 反应良好。随后进行了挽救性手术以切除残余肿瘤。组织病理学检查显示，分离的组织中心含有肿瘤细胞，周围组织显示出严重的纤维化。然而，照射区域以外的组织几乎没有纤维化。BNCT 可能使放射治疗后的挽救性手术更容易进行，因为它对周围组织的损伤比常规放射治疗小。我们的经验表明，对于无法手术的病变或强烈希望保留功能的患者，BNCT 可能是一种可行的术前治疗方法。
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