Laskar Sarbani Ghosh, Kumar Anuj, Sharma Prashasti, Budrukkar Ashwini, Swain Monali, Sinha Shwetabh, Mohanty Samarpita, Anaz Muhammed, Kale Shrikant
Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India.
Department of Medical Physics, Tata Memorial Centre, Mumbai, India.
J Contemp Brachytherapy. 2025 Jun;17(3):174-182. doi: 10.5114/jcb.2025.152540. Epub 2025 Jun 30.
To evaluate local control, cosmetic outcomes, toxicities, and survival outcomes of interstitial high-dose-rate (HDR) brachytherapy treatment in non-basal cell carcinoma malignancies of the eyelid.
This retrospective study analyzed patients with histopathologically confirmed eyelid malignancies treated with adjuvant HDR interstitial brachytherapy (Ir) between August 2007 and August 2024. Outcomes assessed included loco-regional control (LRC), disease-free survival (DFS), overall survival (OS), and toxicities graded by the Radiation Therapy Oncology Group (RTOG). Kaplan-Meier analysis estimated survival rates, while cosmetic outcomes were evaluated using cosmetic assessment of intraocular brachytherapy (CAIB) scale.
Eighteen patients with sebaceous (72.2%) and squamous (22.2%) histologies received 21-49 Gy in 7-14 frac-tions (3-3.5 Gy/fraction). With a median follow-up of 21.93 (IQR, 10.6-152.83) months, no loco-regional recurrences were observed among 13 patients with documented follow-up (LRC, 100%). Two patients died (one from systemic progression without local failure and the other from COVID-19), and three were lost to follow-up. The 5-year OS and DFS rates were 83.3%. Cosmetic outcomes were rated excellent in 55.55% and very good in 44.44% of patients. No grade 3 and above acute toxicities occurred, and eyelid/eye function was preserved in 88.88% (16/18), ensuring organ preservation without late toxicity.
Adjuvant HDR brachytherapy is a safe and effective treatment for eyelid malignancies, achieving excellent local control, superior cosmetic outcomes, and acceptable toxicity. This modality optimizes tumor control, while preserving function and esthetics in this anatomically sensitive region.
评估间质高剂量率（HDR）近距离放射治疗对眼睑非基底细胞癌恶性肿瘤的局部控制、美容效果、毒性和生存结果。
这项回顾性研究分析了2007年8月至2024年8月期间接受辅助HDR间质近距离放射治疗（铱）且经组织病理学确诊的眼睑恶性肿瘤患者。评估的结果包括局部区域控制（LRC）、无病生存期（DFS）、总生存期（OS）以及由放射肿瘤学组（RTOG）分级的毒性。采用Kaplan-Meier分析估计生存率，同时使用眼内近距离放射治疗美容评估（CAIB）量表评估美容效果。
18例皮脂腺（72.2%）和鳞状（22.2%）组织学类型的患者接受了21 - 49 Gy的剂量，分7 - 14次给予（每次3 - 3.5 Gy）。中位随访时间为21.93（四分位间距，10.6 - 152.83）个月，在13例有记录随访的患者中未观察到局部区域复发（LRC，100%）。2例患者死亡（1例死于全身进展无局部失败，另1例死于COVID - 19），3例失访。5年总生存期和无病生存期率为83.3%。55.55%的患者美容效果评为优秀，44.44%评为非常好。未发生3级及以上急性毒性反应，88.88%（16/18）的患者眼睑/眼功能得以保留，确保了器官保留且无晚期毒性。
辅助HDR近距离放射治疗是治疗眼睑恶性肿瘤的一种安全有效的方法，可实现出色的局部控制、卓越的美容效果和可接受的毒性。这种治疗方式优化了肿瘤控制，同时在这个解剖学敏感区域保留了功能和美观。
