Radiation Oncology Department, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
Biostatistics Department, Institut de cancérologie de Lorraine, Vandœuvre-lès-Nancy, France.
Cancer Radiother. 2024 Apr;28(2):145-151. doi: 10.1016/j.canrad.2023.06.031. Epub 2023 Dec 9.
Low-dose-rate (LDR) and high-dose-rate (HDR) interstitial brachytherapy are known to be effective in the treatment of lip carcinomas. The aim of this study was to retrospectively compare oncologic and toxicity outcomes between the two techniques.
From 2007 to 2018, patients at the Institut de cancérologie de Lorraine (France) who received exclusive or adjuvant interstitial brachytherapy for lip squamous carcinomas were studied. Two groups were defined: the LDR/PDR group, including patients treated with iridium-192 wires, or pulsed-dose rate technique, and the high-dose-rate group, with patients treated by high-dose-rate technique. The dose ranged between 50Gy and 65Gy (depending on previous surgery) for low-dose-/pulsed-dose rate treatments, and 39Gy for high-dose-rate (twice a day). Early, late toxicity events and oncologic control were reported.
Among the 61 patients whose data were analyzed retrospectively, 36 received the low-dose-/pulsed-dose rate treatment (59%) and 25 the high-dose-rate brachytherapy (41%). The median follow-up time was 44 months. At 36 months, the local control rates were 96.3% for LDR/PDR group and 100% for HDR (P=0.180). The regional control rates were 85.9% and 92% without any difference according to the two groups (P=0.179). The specific overall survival rate was 95.5% with no difference between groups. There were more grade 2 or higher mucositis in the HDR group than in LDR/PDR group (40% versus 16.7%, P=0.042). One case of grade 3 mucositis was recorded in each group. No grade 3 late complications were recorded. High-dose-rate brachytherapy reduced the length of hospitalization by 2 days (P<0.001).
High-dose- or low-dose-/pulsed-dose rate brachytherapy seemed to be as effective and well tolerated in our experience of 61 patients.
低剂量率（LDR）和高剂量率（HDR）间质近距离放疗已被证实可有效治疗唇癌。本研究旨在回顾性比较两种技术的肿瘤学和毒性结果。
自 2007 年至 2018 年，法国洛林癌症研究所（Institut de cancérologie de Lorraine）的患者接受了专用于唇鳞癌的间质近距离放疗。将患者分为两组：LDR/PDR 组，包括接受铱-192 线或脉冲剂量率技术治疗的患者；HDR 组，包括接受高剂量率技术治疗的患者。低剂量/脉冲剂量率治疗的剂量范围为 50Gy 至 65Gy（取决于先前的手术），高剂量率治疗的剂量为 39Gy（每日两次）。报告了早期、晚期毒性事件和肿瘤控制情况。
在回顾性分析的 61 例患者数据中，36 例接受了低剂量/脉冲剂量率治疗（59%），25 例接受了高剂量率近距离放疗（41%）。中位随访时间为 44 个月。36 个月时，LDR/PDR 组的局部控制率为 96.3%，HDR 组为 100%（P=0.180）。两组的区域控制率分别为 85.9%和 92%，无显著差异（P=0.179）。特异性总生存率为 95.5%，两组间无差异。HDR 组的 2 级或更高级别的黏膜炎发生率高于 LDR/PDR 组（40%比 16.7%，P=0.042）。两组各有 1 例 3 级黏膜炎病例。未记录到 3 级晚期并发症。高剂量率近距离放疗将住院时间缩短了 2 天（P<0.001）。
在我们对 61 例患者的经验中，高剂量率或低剂量/脉冲剂量率近距离放疗似乎同样有效且耐受良好。
