采用间隙、表面或间隙与表面模塑技术相结合的高剂量率近距离放射治疗唇癌。

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2025-01-01 DOI:10.1016/j.brachy.2024.09.004

Serhii Brovchuk , Zoia Shepil , Puja Venkat , Oleg Vaskevych , Sang-June Park

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引用次数: 0

摘要

目的：在唇癌治疗中，高剂量率近距离放射治疗（HDR-BT）比低剂量率和脉冲剂量率近距离放射治疗更为常见。然而，由于 HDR-BT 的历史有限，已发表的研究相对较少。两家机构（乌克兰和美国）回顾了唇癌患者接受 HDR-BT 单药治疗或联合体外放射治疗（EBRT）的临床疗效：根据肿瘤侵犯的深度，采用间质（IS）、表面定制模（SC）或间质和SC（IS+SC）组合进行治疗。与46-50 Gy的EBRT联合治疗时，处方剂量为24 Gy，分6次服用；IS和IS+SC单药治疗时，处方剂量为45-55 Gy，分9-10次服用；SC单药治疗时，处方剂量为3 Gy × 16每日分次服用：2015年至2021年共治疗了33例唇癌患者。根据TNM分期分类，唇癌Ⅰ期14例（42.4%），Ⅱ期15例（45.5%），Ⅲ期4例（12.1%）。31名患者（93.9%）对治疗有完全反应。只有 2 名患者（6.1%）出现局部复发。分别有30.3%、51.5%和18.2%的患者出现1、2和3级急性毒性反应。39.4%、21.2% 和 0.0% 的病例出现了 1、2 和 3 级晚期毒性反应。21.2%的患者美容效果极佳，54.5%的患者美容效果良好，18.2%的患者美容效果一般，6.1%的患者美容效果较差：HDR-BT是一种有效、安全的唇癌治疗方法，具有良好的局部控制、功能和美容效果，应被视为一种标准治疗方法。

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High dose rate brachytherapy for lip cancer with interstitial, surface, or a combination of interstitial and surface mold technique

PURPOSE

High-dose-rate brachytherapy (HDR-BT) is now becoming more common than low-dose-rate and pulsed-dose-rate BT in the treatment of lip cancer. However, due to the limited history of HDR-BT, relatively few studies have been published. Two institutions (in Ukraine and the USA) reviewed their clinical outcomes of lip cancer patients treated with HDR-BT as monotherapy or in combination with external beam radiotherapy (EBRT).

METHODS AND MATERIALS

An interstitial (IS), surface custom mold (SC), or a combination of IS and SC (IS+SC) was used for treatments based on the depth of tumor invasion. Prescription doses were 24 Gy in 6 BID fractions when combined with 46–50 Gy of EBRT, 45–55 Gy in 9–10 BID fractions for IS and IS+SC monotherapy or 3 Gy × 16 daily fractions for SC monotherapy.

RESULTS

A total of 33 cases of lip cancer were treated from 2015 to 2021. By using TNM staging classification, there were 14 stage I (42.4%), 15 stage II (45.5%), and 4 stage III (12.1%) lip cancers. Thirty-one patients (93.9%) had a complete response to the treatment. Only 2 patients (6.1%) displayed local recurrence. Grade 1, 2, and 3 acute toxicities were observed in 30.3%, 51.5%, and 18.2% of patients, respectively. Grade 1, 2, and 3 late toxicities were observed in 39.4%, 21.2%, and 0.0% of cases. Cosmetic results were excellent in 21.2%, good in 54.5%, fair in 18.2%, and poor in 6.1% of patients.

CONCLUSIONS

HDR-BT is an effective and safe treatment for lip carcinomas with excellent local control, functional, and cosmetic outcomes and should be considered as a standard treatment.

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.