Zhong Allison Y, Kim Sangwoo S, Hopper Austin, White Greg, Miyauchi Sayuri, Jones Riley N, Scanderbeg Dan, Mell Loren K, Weihe Elizabeth, Boutros Nathalie, Doggett Stephen W, Sharabi Andrew B
Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA, USA.
Department of Radiology, University of California San Diego, La Jolla, CA, USA.
Radiat Oncol J. 2024 Sep;42(3):237-243. doi: 10.3857/roj.2024.00325. Epub 2024 Sep 10.
Adenoid cystic carcinoma is a malignancy that is difficult to treat and often metastasizes to the lung. Systemic chemotherapies are not effective for this tumor type, thus local therapies are frequently used. Here, we report a case demonstrating the use of extensive ablative interventions in controlling the progression of metastatic adenoid cystic carcinoma. A patient with adenoid cystic carcinoma developed numerous metastases to his lungs and liver. Local ablative therapies including interstitial brachytherapy and SBRT were used to treat approximately 80 different metastases over the course of a decade. Over 850 brachytherapy seeds were implanted in this patient, and the tumor control and patient outcome were good. As of the most recent follow-up in March 2024, the patient has survived for approximately 12 years since his diagnosis of adenoid cystic carcinoma. To our knowledge, this case represents the most brachytherapy treatments reported in a single patient. It highlights the utility of interstitial brachytherapy and SBRT in treating extensive lung and liver metastases.
腺样囊性癌是一种难以治疗且常转移至肺部的恶性肿瘤。全身化疗对这种肿瘤类型无效，因此经常使用局部治疗。在此，我们报告一例展示广泛消融干预在控制转移性腺样囊性癌进展中的应用的病例。一名腺样囊性癌患者出现了肺部和肝脏的多处转移。在十年间，采用包括组织间近距离放疗和立体定向体部放疗（SBRT）在内的局部消融治疗，治疗了约80处不同转移灶。该患者植入了超过850颗近距离放疗粒子，肿瘤得到控制，患者预后良好。截至2024年3月的最近一次随访，该患者自诊断腺样囊性癌以来已存活约12年。据我们所知，该病例是单一患者接受近距离放疗治疗次数最多的报道。它凸显了组织间近距离放疗和立体定向体部放疗在治疗广泛的肺和肝转移中的效用。
