Combined external radiotherapy and single-fraction palliative high-dose-rate interstitial brachytherapy for a patient with a base of tongue cancer who had a previous radiation history.

IF 1.6 3区 医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE
Ken Yoshida, Yutaka Tanaka, Satoaki Nakamura, Asami Yoshida, Midori Yui, Kazuki Hirota, Katsuya Maebou, Zeyun Wang, Hideki Takegawa, Yusuke Anetai, Yuhei Koike, Toshiko Shiga, Hironori Akiyama, Naoya Murakami, Airi Asako, Yuhei Ogino, Hitoshi Nishimoto, Takuo Fujisawa, Masao Yagi, Hiroshi Iwai, Noboru Tanigawa
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引用次数: 0

Abstract

Only a few studies have explored whether high-dose-rate interstitial brachytherapy (HDR-ISBT) can be indicated as a palliative/symptomatic treatment. We present the good results of palliative treatment using HDR-ISBT combined with external beam radiotherapy (ERT) in a patient of base of tongue cancer (cT4aN1M0). The patient was an 81-year-old male who complained of local pain. He had a previous irradiation history for head and neck cancer receiving ERT with systemic chemotherapy and radical surgery 15 years ago. Since it might be difficult for him to receive radical radiation doses using ERT alone, palliative ERT of relatively lower doses of 37.5 Gy in 15 fractions was selected. One month after ERT, HDR-ISBT was implemented as a booster. Considering the burden on physical condition, single-fraction HDR-ISBT was selected. We employed a new technique in which we did not penetrate the ventral surface of the tongue to reduce the risk of infection and bleeding. The planning-aim dose was 9.5 Gy. The dose that covered 90% of the clinical target volume was 9.6 Gy. The treatment ended without any problems. Acute complications were not observed. The tumor size decreased, and local pain disappeared at post-treatment day 84. No late complications were observed. Two years and 8 months after the treatment, the patient is alive without any obvious recurrence. Additional single-fraction HDR-ISBT boost may be a useful modality as a palliative/symptomatic intent. The implantation technique and dose-fraction schedule may be important for the safe treatment of older patients or those with poor performance status.

为一名曾接受过放射治疗的舌底癌患者实施了联合外放射治疗和单分次姑息性高剂量率间质近距离放射治疗。
只有少数研究探讨了高剂量率间质近距离放射治疗(HDR-ISBT)是否可用作姑息/症状治疗。我们介绍了在一名舌底癌(cT4aN1M0)患者中使用 HDR-ISBT 联合体外放射治疗(ERT)进行姑息治疗的良好效果。患者是一名81岁的男性,主诉局部疼痛。15 年前,他曾因头颈部癌症接受过 ERT 和全身化疗,并接受过根治手术。由于他可能难以单独接受根治性放射剂量,因此选择了剂量相对较低的姑息性 ERT,即 37.5 Gy,分 15 次进行。ERT 一个月后,他接受了 HDR-ISBT 作为辅助治疗。考虑到对身体状况造成的负担,我们选择了单剂量 HDR-ISBT。我们采用了一种新技术,即不穿透舌腹面,以降低感染和出血风险。计划瞄准剂量为 9.5 Gy。覆盖90%临床靶体积的剂量为9.6 Gy。治疗顺利结束。未观察到急性并发症。治疗后第 84 天,肿瘤缩小,局部疼痛消失。未观察到晚期并发症。治疗后两年零八个月,患者仍健在,无明显复发。额外的单剂量 HDR-ISBT 增效可能是一种有效的姑息/症状缓解方式。植入技术和剂量-分次计划可能对老年患者或表现不佳的患者的安全治疗非常重要。
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来源期刊
Oral Radiology
Oral Radiology DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.20
自引率
13.60%
发文量
87
审稿时长
>12 weeks
期刊介绍: As the official English-language journal of the Japanese Society for Oral and Maxillofacial Radiology and the Asian Academy of Oral and Maxillofacial Radiology, Oral Radiology is intended to be a forum for international collaboration in head and neck diagnostic imaging and all related fields. Oral Radiology features cutting-edge research papers, review articles, case reports, and technical notes from both the clinical and experimental fields. As membership in the Society is not a prerequisite, contributions are welcome from researchers and clinicians worldwide.
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