Zhao Genghao, Wang Zhe, Li Chuang, Chen Songbai, Yang Liang, Wu Jinyu, Zhou Dong, Ju Zaishaung, Zhou Jun, Wang Ruoyu
Department of Medical Oncology, Affiliated Zhongshan Hospital of Dalian University, Dalian 116001, P. R. China.
The Key Laboratory of Biomarker High Throughput Screening and Target Translation of Breast and Gastrointestinal Tumor, Dalian University, Dalian 116001, P. R. China.
J Contemp Brachytherapy. 2022 Dec;14(6):519-526. doi: 10.5114/jcb.2022.123971. Epub 2022 Dec 30.
The aim of the present study was to assess the clinical efficacy and safety of stereotactic ablative brachytherapy (SABT) for unresectable or inoperable head and neck cancers.
This study retrospectively assessed clinical data of 37 patients with unresectable or inoperable head and neck cancers treated with SABT from October 2016 to October 2021. Variables evaluated included local efficacy, local control rate (LCR), overall survival (OS) rate, and radiological adverse effects.
The median follow-up was of 34 months (range, 5-59 months), and LCR at 6, 12, and 24 months was 89.2%, 78.2%, and 69.4%, respectively. The median survival time was 16 months [95% confidence interval (CI): 10.5-21.5 months], and the OS rate at 6, 12, and 24 months was 97.3%, 70.3%, and 34.5%, respectively. The results of univariate analysis revealed that the type of pathology and gross tumor volume (GTV) D were related to LCR ( < 0.05). However, the type of pathology, GTV D, age, and implantation site were related to OS rate ( < 0.05). The results of multivariate analysis showed that the type of pathology and GTV D were substantially related to LCR and OS rate ( < 0.05). The evaluation of post-operative radiological adverse reactions revealed that seven cases (18.9%) developed grade 1-2 skin reactions, four cases (10.8%) developed grade 1-2 oral mucosal outcomes, and no cases developed grade 3 or higher adverse reactions. Post-operative seed dislocation occurred in three patients with tongue cancer.
SABT has produced good local control and mild adverse reactions in the treatment of unresectable or inoperable head and neck cancers. Additionally, it is safe, feasible, minimally invasive, and has fewer adverse effects than other treatment modalities.
本研究旨在评估立体定向消融近距离放射治疗（SABT）用于不可切除或无法手术的头颈癌的临床疗效和安全性。
本研究回顾性评估了2016年10月至2021年10月期间接受SABT治疗的37例不可切除或无法手术的头颈癌患者的临床资料。评估的变量包括局部疗效、局部控制率（LCR）、总生存率（OS）以及放射学不良反应。
中位随访时间为34个月（范围5 - 59个月），6个月、12个月和24个月时的LCR分别为89.2%、78.2%和69.4%。中位生存时间为16个月[95%置信区间（CI）：10.5 - 21.5个月]，6个月、12个月和24个月时的OS率分别为97.3%、70.3%和34.5%。单因素分析结果显示，病理类型和大体肿瘤体积（GTV）D与LCR相关（<0.05）。然而，病理类型、GTV D、年龄和植入部位与OS率相关（<0.05）。多因素分析结果表明，病理类型和GTV D与LCR和OS率显著相关（<0.05）。术后放射学不良反应评估显示，7例（18.9%）出现1 - 2级皮肤反应，4例（10.8%）出现1 - 2级口腔黏膜反应，无3级或更高级别不良反应发生。3例舌癌患者术后发生粒子移位。
SABT在治疗不可切除或无法手术的头颈癌方面产生了良好的局部控制效果且不良反应轻微。此外，它安全、可行、微创，且与其他治疗方式相比不良反应更少。
