Takahashi Satoru, Endo Masashi, Nagatomo Takafumi, Onaga Ryutaro, Yamaguchi Hironori, Yamamoto Rie, Fukuda Yukiko, Ogawa Kazunari, Nakamura Michiko, Okada Kohei, Akahane Keiko, Kawahara Masahiro, Nishino Hiroshi, Kanazawa Takeharu, Mori Harushi, Shirai Katsuyuki
Department of Radiology, Jichi Medical University Hospital, Tochigi, Japan.
Department of Otolaryngology, Jichi Medical University Hospital, Tochigi, Japan.
Case Rep Oncol. 2023 Apr 14;16(1):218-226. doi: 10.1159/000529829. eCollection 2023 Jan-Dec.
QUAD SHOT is an ultra-hypofractionated radiotherapy (RT) technique that prescribes 14.0-14.8 Gy over 2 days. Although this technique has already gained some status as an effective palliative treatment for inoperable head and neck cancer (HNC), its application in other situations has not been given much consideration. Herein, we report a case of a 62-year-old woman who received preoperative QUAD SHOT therapy for poorly differentiated parotid carcinoma. In this case, after two courses of QUAD SHOT plus a standard chemotherapy regimen with pembrolizumab, the patient's inoperable, bulky tumor shrank dramatically and became operable. Best of all, while adequate therapeutic effects were achieved, the patient's time commitment and physical exertion were limited. RT during this period consisted of only eight fractions over 4 days. According to previous reports, the response rate for QUAD SHOT is sufficiently high, and the rate of serious adverse events is quite low. This case asks the question of whether the indications for QUAD SHOT irradiation can be expanded as one of the preoperative interventions undertaken by HNC surgeons to achieve conversion surgery.
四分割放疗是一种超分割放疗（RT）技术，在2天内给予14.0 - 14.8 Gy的剂量。尽管该技术作为不可切除头颈部癌（HNC）的有效姑息治疗方法已获得一定地位，但其在其他情况下的应用尚未得到充分考虑。在此，我们报告一例62岁女性，她接受了术前四分割放疗治疗低分化腮腺癌。在该病例中，经过两个疗程的四分割放疗加用帕博利珠单抗的标准化疗方案后，患者原本不可切除的巨大肿瘤显著缩小，变得可以切除。最棒的是，在取得充分治疗效果的同时，患者所需的时间和体力消耗都有限。在此期间的放疗仅在4天内进行了8次分割。根据先前的报告，四分割放疗的缓解率足够高，严重不良事件发生率相当低。该病例引发了一个问题，即四分割放疗的适应证是否可以扩大，作为HNC外科医生进行转化手术的术前干预措施之一。
