Treatment of recurrent pelvic and selected primary gynecologic malignancies with 241Am.

J Y Chung, K Roberts, R E Peschel, R Nath, R Pourang, B Kacinski, L Wilson
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引用次数: 6

Abstract

The purpose of this study was to update the experience and demonstrate the effectiveness and limitations of 241Am applicators for previously irradiated patients and for selected patients with primary gynecologic malignancies. Between October 1986 and May 1994, 30 patients were treated with 241Am. The median patient age was 68 years, ranging from 41 to 91 years. Patients were retrospectively categorized by treatment intent, i.e., palliative vs. curative. Patients undergoing curative therapy were further classified as to whether 241Am brachytherapy was directed at microscopic residua after surgery or to gross primary tumor. Of the 30 patients, 18 had recurrent pelvic malignancies from various primary sites and were reirradiated with 241Am for palliation. Six patients had microscopic disease after surgical resection and were managed with postoperative radiotherapy (RT) that included 241Am. Six patients had gynecologic cancers managed with primary RT that included treatment with 241Am. Overall, 50% (9/18) of the patients with recurrent pelvic malignancies were locally controlled after reirradiation with 241Am. Including surgical salvage, the ultimate local control rate was 61% (11/18). Postoperative 241Am with or without external beam radiation therapy (XRT) was effective in 83% (5/6) of the patients with microscopic disease. Including surgical salvage, 100% (6/6) of the patients were ultimately free of disease. Fifty percent (3/6) of the patients treated with primary RT that included 241Am brachytherapy experienced local control. Including surgical salvage, 67% (4/6) of the patients were ultimately controlled with 241Am. In conclusion, reirradiation utilizing 241Am was effective in palliating patients with recurrent pelvic malignancies. 241Am was effective in 83% (5/6) of the patients with microscopic disease managed with postoperative RT. 241Am was of marginal benefit in patients with gynecologic tumors managed with primary RT.

241Am治疗复发性盆腔及部分原发性妇科恶性肿瘤。
本研究的目的是更新经验,并证明241Am涂抹器对既往放疗患者和选定的原发性妇科恶性肿瘤患者的有效性和局限性。1986年10月至1994年5月,30名患者接受了241Am治疗。患者年龄中位数为68岁,范围从41岁到91岁。根据治疗意图对患者进行回顾性分类,即姑息治疗与治愈治疗。接受根治性治疗的患者进一步分类,241Am近距离放疗是针对术后显微残留还是肉眼原发肿瘤。在30例患者中,18例患有不同原发部位的盆腔恶性肿瘤复发,并再次接受241Am放射治疗以缓解病情。6例患者在手术切除后出现显微病变,并接受术后放疗(RT),其中包括241Am。6例妇科癌症患者接受了包括241Am治疗在内的原发性放疗。总体而言,50%(9/18)的盆腔恶性肿瘤复发患者在241Am再照射后得到局部控制。包括手术挽救,最终局部控制率为61%(11/18)。术后241Am加或不加外束放射治疗(XRT)对83%(5/6)的显微病变患者有效。包括手术挽救在内,100%(6/6)的患者最终摆脱疾病。50%(3/6)接受包括241Am近距离放射治疗的原发性放疗的患者经历了局部控制。包括手术挽救在内,67%(4/6)的患者最终得到241Am的控制。综上所述,241Am再照射对盆腔恶性肿瘤复发患者是有效的。241Am在83%(5/6)的显微病变术后放疗患者中有效,而在原发性妇科肿瘤术后放疗患者中,241Am的边际效益较低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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