Department of Oral and Maxillofacial Radiology, Hiroshima University Hospital, Hiroshima, Japan;
Department of Radiation Oncology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
Anticancer Res. 2023 May;43(5):2265-2271. doi: 10.21873/anticanres.16390.
BACKGROUND/AIM: The aim of this study was to investigate the use of spacers and their efficacy in brachytherapy with Au grains for buccal mucosa cancer.
Sixteen patients with squamous cell carcinoma of the buccal mucosa who were treated with Au grain brachytherapy were included. The distance between Au grains, distance between Au grains and the maxilla or mandible, and the maximum dose/cc to the jawbone (D1cc) with and without a spacer was investigated in three out of 16 patients.
The median distance between Au grains without and with a spacer was 7.4 and 10.7 mm, respectively; this was significantly different. The median distance between Au grains and the maxilla without and with a spacer was 10.3 and 18.5 mm, respectively; again this was significantly different. The median distance between Au grains and the mandible without and with a spacer was 8.6 and 17.3 mm, respectively; the difference was significant. The D1cc to the maxilla without and with a spacer were 14.9, 68.7, and 51.8 Gy and 7.5, 21.2, and 40.7 Gy in cases 1, 2, and 3, respectively. The D1cc to the mandible without and with a spacer were 27.5, 68.7, and 85.8 Gy and 11.3, 53.6, and 64.9 Gy in cases 1, 2, and 3, respectively. No osteoradionecrosis of the jaw bones was observed in any case.
The spacer enabled maintenance of the distance between Au grains, and between Au grains and the jawbone. In buccal mucosa cancer, using a spacer in brachytherapy with Au grains appears to reduce jawbone complications.
背景/目的:本研究旨在探讨使用间隔物在金(Au)颗粒近距离放射治疗颊黏膜癌中的应用及其疗效。
纳入 16 例颊黏膜鳞状细胞癌患者,接受 Au 颗粒近距离放射治疗。在 3 例患者中,研究了 Au 颗粒之间的距离、Au 颗粒与上颌骨或下颌骨之间的距离以及无间隔物和有间隔物时颌骨的最大剂量/cc(D1cc)。
无间隔物和有间隔物时 Au 颗粒之间的中位距离分别为 7.4 和 10.7mm,差异有统计学意义。无间隔物和有间隔物时 Au 颗粒与上颌骨之间的中位距离分别为 10.3 和 18.5mm,差异有统计学意义。无间隔物和有间隔物时 Au 颗粒与下颌骨之间的中位距离分别为 8.6 和 17.3mm,差异有统计学意义。病例 1、2 和 3 中,无间隔物和有间隔物时上颌骨 D1cc 分别为 14.9、68.7 和 51.8Gy 以及 7.5、21.2 和 40.7Gy。病例 1、2 和 3 中,无间隔物和有间隔物时下颌骨 D1cc 分别为 27.5、68.7 和 85.8Gy 以及 11.3、53.6 和 64.9Gy。所有病例均未观察到颌骨放射性骨坏死。
间隔物可保持 Au 颗粒之间以及 Au 颗粒与颌骨之间的距离。在颊黏膜癌中,Au 颗粒近距离放射治疗中使用间隔物可降低颌骨并发症的风险。