Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
National Center of Stomatology and National Clinical Research Center for Oral Diseases and National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.
Pediatr Blood Cancer. 2023 Jan;70(1):e30037. doi: 10.1002/pbc.30037. Epub 2022 Oct 2.
Desmoid tumor (DT) is rare and challenging, often affects the head and neck (HN) region in children, and its appropriate treatments are under-discussed. This study aimed to retrospectively evaluate the long-term effectiveness and safety of I seed brachytherapy for pediatric DT in HN.
Seven pediatric patients with a median age of three years who suffered from DT in HN treated with I brachytherapy from January 2008 to June 2018 were included. Among these, five underwent sole brachytherapy and the others combined with surgery under prescription doses ranging from 10,000 to 12,000 cGy. The rate of local control (LC), complete response (CR), and partial response (PR) was calculated after evaluation by radiological and pathological means. Radiation-associated toxicities were also evaluated.
The LC rate was 7/7 during the follow-up time ranging from 43 to 135 months and with a mean of 57 months. No recurrent lesion was found in the patients receiving surgery combined with brachytherapy. In patients treated with sole brachytherapy, the radiological PR rate and CR rate were 4/5 and 1/5, respectively. In those reaching radiological PR, 3/4 were pathological CR. Slight acute radiation-associated toxicities were observed in all patients, and no late or severe acute toxicity was observed.
I brachytherapy is effective and safe in the management of pediatric DT in HN as the sole modality or combined with surgery in the long term.
韧带样瘤（desmoid tumor，DT）罕见且具有挑战性，常发生于儿童头颈部，其适当的治疗方法尚未得到充分讨论。本研究旨在回顾性评估 I 粒子近距离放射治疗儿童头颈部 DT 的长期疗效和安全性。
纳入 2008 年 1 月至 2018 年 6 月期间，7 例头颈部 DT 患儿接受 I 粒子近距离放射治疗。5 例单纯接受近距离放射治疗，另 2 例根据处方剂量（10000-12000cGy）选择手术联合治疗。通过影像学和病理学手段评估，计算局部控制率（LC）、完全缓解率（CR）和部分缓解率（PR）。评估放射性相关毒性。
在 43-135 个月的随访时间内，7/7 例患者 LC 率为 100%。手术联合近距离放射治疗的患者中未发现复发病灶。单纯接受近距离放射治疗的患者中，4/5 例患者的影像学 PR 率和 CR 率分别为 80%和 20%。达到影像学 PR 的患者中，4/4 例为病理学 CR。所有患者均观察到轻微的急性放射性相关毒性，无迟发性或严重的急性毒性。
I 粒子近距离放射治疗是一种有效的治疗方法，无论是作为单一治疗方式还是与手术联合治疗，在长期治疗儿童头颈部 DT 方面都是安全的。
