Friedrich R E, Krüll A, Hellner D, Schwarz R, Heyer D, Plambeck K, Schmelzle R
Department of Oral & Maxillofacial Surgery, Eppendorf University Hospital, University of Hamburg, Germany.
J Craniomaxillofac Surg. 1995 Aug;23(4):238-42. doi: 10.1016/s1010-5182(05)80214-8.
Thirty-four patients with recurrent oral and oropharyngeal carcinomas were treated over a period of 4 years, by interstitial high-dose rate (HDR) brachytherapy (BT) using an iridium-192 source (Gammamed 2i and 12i equipment, Sauerwein, Germany) and fractionated application (1 up to 3 times, weekly recovery phases, single maximum dose 10 Gy). Pretreatment characteristics of patients in terms of irradiation (RT) and surgery differed (22 had external RT alone, with a total dose between 60.0 and 75.6 Gy; RT and surgery: 7; surgery alone: 1). The initial TNM-stages (UICC, Hermanek et al., 1987) of patients were: I = 2, II =3, III = 7, IV = 22. In the majority of cases, clinical indications for HDR-BT included tumour recurrence or progression following external RT, and second primary tumours of the oral cavity. Therapy was successful in most cases, i.e. complete remission: 11, partial remission: 16, no change: 2, progression: 5. Local control and overall survival rates, including patients surgically treated after BT, were at 6 months 58% and 62%, and 44% and 53% at 12 months, respectively. This type of treatment is recommended in patients with local recurrence or second primary tumours after previous external RT in the head and neck region. However, the benefit of interstitial HDR-BT remains questionable, particularly in patients with large tumours and lymph node metastases.
在4年的时间里，对34例复发性口腔和口咽癌患者进行了治疗，采用铱-192源（德国Sauerwein公司的Gammamed 2i和12i设备）进行组织间高剂量率（HDR）近距离放射治疗（BT），并采用分次照射（1至3次，每周恢复期，单次最大剂量10 Gy）。患者在放疗（RT）和手术方面的预处理特征有所不同（22例仅接受外照射放疗，总剂量在60.0至75.6 Gy之间；放疗和手术联合治疗：7例；仅手术治疗：1例）。患者的初始TNM分期（UICC，Hermanek等人，1987年）为：I期 = 2例，II期 = 3例，III期 = 7例，IV期 = 22例。在大多数情况下，HDR-BT的临床适应症包括外照射放疗后肿瘤复发或进展，以及口腔第二原发肿瘤。大多数病例治疗成功，即完全缓解：11例，部分缓解：16例，无变化：2例，进展：5例。包括BT后接受手术治疗的患者在内，局部控制率和总生存率在6个月时分别为58%和62%，在12个月时分别为44%和53%。对于头颈部区域先前接受外照射放疗后出现局部复发或第二原发肿瘤的患者，推荐这种治疗方式。然而，组织间HDR-BT的益处仍存在疑问，特别是对于肿瘤较大和有淋巴结转移的患者。
