Cua Marjorie Mae, Jainar Carl Jay, Calapit Janella Ann Javenrie, Mejia Michael Benedict, Bacorro Warren
Department of Radiation Oncology, Manila Doctors Hospital, Manila, Philippines.
Department of Radiation Oncology, Cardinal Santos Medical Center, San Juan, Philippines.
J Contemp Brachytherapy. 2024 Jun;16(3):225-231. doi: 10.5114/jcb.2024.140348. Epub 2024 Jun 6.
Since the last update of GEC-ESTRO (Groupe Européen de Curiethérapie - European Society for Therapeutic Radiology and Oncology) recommendations for head and neck (HN) brachytherapy in 2017, advances in understanding and management of HN cancers have influenced brachytherapy. We conducted a scoping review to depict the evolution of HN brachytherapy research and practice, and identify emerging topics since the previously published guidelines.
Systematic literature search was performed in PubMed, EBSCOhost, Europe PMC, and Google Scholar databases for articles on HN brachytherapy from 2017 onwards; the search was last done on June 29, 2023. We included primary studies on HN brachytherapy in English, complemented by bibliography scanning of secondary studies. Iterative team approach was employed in data extraction and charting. Quantitative and qualitative analyses and narrative synthesis were performed.
Systematic search yielded 215 unique articles. A total of 132 primary studies were included: 112 on clinical outcomes (retrospective cohorts in majority, = 72), and 22 were simulation and dosimetric studies. China consistently produced the most research output per year. The most studied sites were the oral cavity ( = 84), oropharynx ( = 37), and salivary glands ( = 20). While most reported on high-dose-rate brachytherapy ( = 57), there was resurgence of studies on low-dose-rate (LDR) brachytherapy ( = 50) in the form of permanent seed implants. In the latter, CT ( = 50) and template ( = 27) guidance were described. While majority discussed definitive brachytherapy, 18 reported on perioperative brachytherapy. Several reported on 3D printing for template and applicator design ( = 11) as well as new approaches to dose calculation or dose optimization algorithms ( = 2).
The current scoping review identified recent trends in HN brachytherapy, such as application in other HN sites, use of LDR seed implants, perioperative brachytherapy, and 3D printing in template design. Data from these recent publications provide a foundation for further investigations, which can generate evidence for succeeding guidelines.
自2017年欧洲近距离放射治疗-欧洲放射治疗与肿瘤学会（GEC-ESTRO）对头颈部（HN）近距离放射治疗的建议进行上次更新以来，对HN癌症的认识和管理进展已影响到近距离放射治疗。我们进行了一项范围综述，以描述HN近距离放射治疗研究和实践的演变，并确定自先前发布指南以来出现的新主题。
在PubMed、EBSCOhost、欧洲生物医学中心（Europe PMC）和谷歌学术数据库中对2017年起关于HN近距离放射治疗的文章进行系统文献检索；最后一次检索于2023年6月29日进行。我们纳入了英文的HN近距离放射治疗的原始研究，并辅以对二次研究的文献扫描。在数据提取和制表过程中采用了迭代团队方法。进行了定量和定性分析以及叙述性综合。
系统检索产生了215篇独特的文章。共纳入132项原始研究：112项关于临床结果（大多数为回顾性队列研究，n = 72），22项为模拟和剂量学研究。中国每年的研究产出始终最多。研究最多的部位是口腔（n = 84）、口咽（n = 37）和唾液腺（n = 20）。虽然大多数报告的是高剂量率近距离放射治疗（n = 57），但以永久性粒子植入形式的低剂量率（LDR）近距离放射治疗研究有所复兴（n = 50）。在后一种情况下，描述了CT引导（n = 50）和模板引导（n = 27）。虽然大多数讨论的是根治性近距离放射治疗，但有18项报告了围手术期近距离放射治疗。有几项报告了用于模板和施源器设计的3D打印（n = 11）以及剂量计算或剂量优化算法的新方法（n = 2）。
当前的范围综述确定了HN近距离放射治疗的近期趋势，如在其他HN部位的应用、LDR粒子植入的使用、围手术期近距离放射治疗以及模板设计中的3D打印。这些近期出版物的数据为进一步研究提供了基础，可为后续指南提供证据。
