Neu Maria, Kahl Klaus-Henning, Körner Melina, Walter Renate, Raab Stephan, Jehs Bertram, Käsmann Lukas, Strnad Vratislav, Stüben Georg, Balagiannis Nikolaos
Department of Radiotherapy and Radiation Oncology, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany.
Comprehensive Cancer Center Augsburg (CCCA), Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany.
J Clin Med. 2024 Dec 11;13(24):7550. doi: 10.3390/jcm13247550.
: To analyze the results of interstitial (IRT) high-dose-rate (HDR) brachytherapy (BT) in the primary treatment of patients with unresectable superior sulcus tumors (SST) combined with external beam radiotherapy (EBRT). : Between 2013 and 2023, seven patients with unresectable SST were treated with combined BT and EBRT with or without concomitant chemotherapy. The patients' median age was 64 years (range, 49-79 years) and median tumor volume was 146.8 cm (range, 29.3-242.3 cm). A median BT dose of 8 Gray (Gy) (range, 5-10 Gy) was prescribed and delivered in a single fraction. A median EBRT dose of 54 Gy (range, 30-59 Gy) was prescribed and administered normofractionated (single dose: 1.8 Gy). : We report the results of seven patients with SST treated with combined BT and EBRT and followed for a median of 38 months. The overall clinical response rate was 83.33% with five out of six patients achieving local control, while one out of six (16.66%) showed local and general progression. No deaths were attributed to the treatment itself; rather, one patient died during the course of therapy as a result of systemic progression. The most common radiation-related adverse events were grade I-II fatigue and mild paresthesia. No severe toxicity (CTCAE ≥ III°) was observed with interstitial high-dose-rate (HDR) BT combined with EBRT. For patients with unresectable superior sulcus tumors, interstitial HDR BT in combination with EBRT is a feasible treatment option that offers the potential for local control and long-term survival. The findings of this study should be validated in a larger patient cohort.
分析间质性（IRT）高剂量率（HDR）近距离放射治疗（BT）联合外照射放疗（EBRT）对不可切除的肺上沟瘤（SST）患者进行初始治疗的结果。2013年至2023年期间，7例不可切除的SST患者接受了BT联合EBRT治疗，部分患者同时接受了化疗。患者的中位年龄为64岁（范围49 - 79岁），中位肿瘤体积为146.8 cm³（范围29.3 - 242.3 cm³）。BT的中位剂量为8格雷（Gy）（范围5 - 10 Gy），单次分割给予。EBRT的中位剂量为54 Gy（范围30 - 59 Gy），常规分割给予（单次剂量：1.8 Gy）。我们报告了7例接受BT联合EBRT治疗并随访中位时间为38个月的SST患者的结果。总体临床缓解率为83.33%，6例患者中有5例实现局部控制，而6例中有1例（16.66%）出现局部和全身进展。没有死亡归因于治疗本身；相反，1例患者在治疗过程中因全身进展死亡。最常见的放疗相关不良事件为I-II级疲劳和轻度感觉异常。间质性高剂量率（HDR）BT联合EBRT未观察到严重毒性（CTCAE≥III°）。对于不可切除的肺上沟瘤患者，间质性HDR BT联合EBRT是一种可行的治疗选择，具有实现局部控制和长期生存的潜力。本研究结果应在更大的患者队列中进行验证。
