高剂量率腔内近距离放疗外耳道鳞状细胞癌及外束放疗淋巴结覆盖的技术细节及临床结果1例报告。

IF 1.1 4区 医学 Q4 ONCOLOGY
Mark P Dumago, Kelvin Ken L Yu, Luisa E Jacomina, Eugene T Yap, Carl Jay E Jainar, Maureen R Bojador, Adrian F Fernando, Warren R Bacorro, Michael A Mejia
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引用次数: 0

摘要

目的:报告1例淋巴结阳性外耳道(EAC)鳞状细胞癌(SCC)患者采用腔内高剂量(HDR)近距离治疗原发肿瘤和外束放疗(EBRT)引流淋巴的技术细节和15个月的治疗结果。材料和方法:1例21岁男性被诊断为右侧EAC的SCC。患者接受了明确的HDR腔内近距离放疗,340 cGy/次,共14次,每日两次,随后采用调强放疗(IMRT)进行EBRT,覆盖严重肿大的耳前淋巴结、同侧腮腺内淋巴结和颈部淋巴结II和III级。结果:批准的近距离放疗方案平均高危临床肿瘤体积(CTV-HR) D90为341 cGy,总剂量为47.7 Gy (BED, 80.3 Gy, EQD2, 66.6 Gy)。经批准的IMRT方案中,受累右侧耳前淋巴结的处方为66 Gy,分33个分量,95%以上的靶区至少接受62.7 Gy。同时规定高危淋巴结区:1.8 Gy组59.4 Gy, 95%以上接受至少56.4 Gy。危险器官(OARs)保持在剂量限制以下。患者耐受两种治疗方法,无≥2级治疗相关不良事件。在EBRT过程中,右侧耳前和颈部出现1级皮炎。放疗后15个月,患者无疾病迹象,并注意到EAC狭窄,这转化为中度传导性右耳听力损失。EBRT术后15个月甲状腺功能正常。结论:本病例报告表明,在EAC的SCC患者中,放射治疗在技术上是可行的,有效的,并且耐受性良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Technical details and clinical outcomes after high-dose-rate intracavitary brachytherapy for squamous cell carcinoma of external auditory canal and external beam radiotherapy for nodal coverage: A case report.

Technical details and clinical outcomes after high-dose-rate intracavitary brachytherapy for squamous cell carcinoma of external auditory canal and external beam radiotherapy for nodal coverage: A case report.

Technical details and clinical outcomes after high-dose-rate intracavitary brachytherapy for squamous cell carcinoma of external auditory canal and external beam radiotherapy for nodal coverage: A case report.

Technical details and clinical outcomes after high-dose-rate intracavitary brachytherapy for squamous cell carcinoma of external auditory canal and external beam radiotherapy for nodal coverage: A case report.

Purpose: To report technical details and 15-month outcomes of a patient with node-positive external auditory canal (EAC) squamous cell carcinoma (SCC) treated with definitive intracavitary high-dose-rate (HDR) brachytherapy to primary tumor, and external beam radiotherapy (EBRT) to draining lymphatics.

Material and methods: A 21-year-old male was diagnosed with SCC of the right EAC. The patient underwent definitive HDR intracavitary brachytherapy, 340 cGy/fraction for 14 twice-daily fractions, followed by EBRT using intensity-modulated radiation therapy (IMRT) to cover the grossly enlarged pre-auricular node, ipsilateral intra-parotid, and cervical lymph node levels II and III.

Results: The approved brachytherapy plan had an average high-risk clinical tumor volume (CTV-HR) D90 of 341 cGy with a total dose of 47.7 Gy (BED, 80.3 Gy, EQD2, 66.6 Gy). For the approved IMRT plan, the prescription to the involved right pre-auricular node was 66 Gy in 33 fractions, and more than 95% of the target received at least 62.7 Gy. High-risk nodal regions were simultaneously prescribed: 59.4 Gy in 1.8 Gy fractions, and more than 95% received at least 56.4 Gy. Organs at risk (OARs) were kept below their dose constraints.The patient tolerated both the procedures with no grade ≥ 2 treatment-related adverse events. Grade 1 dermatitis in the right pre-auricular and cervical areas during the course of EBRT was experienced. Fifteen months post-RT, the patient has no evidence of disease, and was noted to have EAC stenosis, which translated to moderate conductive hearing loss of the right ear. Thyroid function was normal at 15 months after EBRT.

Conclusions: This case report illustrates that the delivered definitive radiotherapy is technically feasible, effective, and well-tolerated in patients with SCC of EAC.

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来源期刊
Journal of Contemporary Brachytherapy
Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
2.40
自引率
14.30%
发文量
54
审稿时长
16 weeks
期刊介绍: The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.
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