Long-Term Outcomes of Personalized Stereotactic Ablative Brachytherapy for Recurrent Head and Neck Adenoid Cystic Carcinoma after Surgery or External Beam Radiotherapy: A 9-Year Study.
Long-Term Outcomes of Personalized Stereotactic Ablative Brachytherapy for Recurrent Head and Neck Adenoid Cystic Carcinoma after Surgery or External Beam Radiotherapy: A 9-Year Study.
复制标题
DOI：
10.3390/jpm11090839
复制
发表时间：
2021-08-26
影响因子：
--
通讯作者：
Wang J
中科院分区：
文献类型：
--
作者：
Chen Y;Dai J;Jiang Y;Ji Z;Jiang P;Sun H;Xu F;Wang J
头颈部复发的腺样囊性癌(HNACC)的治疗仍然是一个有问题的挑战。本研究旨在评价个体化立体定向消融性近距离放射治疗(SABT)作为挽救HNACC术后复发或外照射(EBRT)的远期疗效。自2011年5月至2019年11月，21例手术或放疗后复发的HNACC患者成功地接受了碘-125(I-125)种子放射治疗。观察两组的客观有效率(ORR)、疾病控制率(DCR)、局部控制时间(LCT)、总生存期(OS)、症状缓解情况和不良反应(AEs)。SABT治疗后ORR和DCR分别为85.7%和100%。3年和5年的LCT率分别为68.8%和55.1%，3年和5年的OS率分别为85.9%和66.2%。此外，单因素分析显示，较高的D90(>；137.1)是预测肿瘤预后的一个较强的积极因素。1例患者术后3个月疼痛消失，9例患者术后1~6个月部分疼痛改善。此外，1例肿瘤累及气管的患者呼吸困难得到缓解。主要不良反应为轻度术中出血和皮肤/粘膜毒性，一般为≤-2级，耐受性良好。个体化的SABT是先前手术或EBRT失败后复发的HNACC的有效和安全的替代选择。D90的参数会对就地控制产生影响。
The management of recurrent head and neck adenoid cystic carcinoma (HNACC) remains a problematic challenge. This study aims to evaluate the long-term outcomes of personalized stereotactic ablative brachytherapy (SABT) as a salvage treatment for recurrent HNACC after surgery or external beam radiotherapy (EBRT). 21 patients with recurrent HNACC after surgery or EBRT successfully underwent iodine-125 (I-125) seed SABT from May 2011 to November 2019. The objective response rate (ORR), disease control rate (DCR), local control time (LCT), overall survival (OS), symptomatic relief and adverse events (AEs) were analyzed. Following SABT, the ORR and DCR were 85.7% and 100%, respectively. The 3-, and 5-year LCT rates were 68.8% and 55.1%, respectively, and the 3- and 5-year OS rates were 85.9% and 66.2%, respectively. Furthermore, univariate analyses showed that higher D90 (>137.1 Gy) was a strong positive prognostic factor of LCT (p < 0.05). The pain disappeared in one patient 3 months after SABT and partial pain improvement was observed in nine patients 1 to 6 months after SABT. Additionally, dyspnea was relieved in one patient with the tumor involving the trachea. The major AEs were mild intraoperative hemorrhage and skin/mucosal toxicities which were generally graded ≤2 and well-tolerated. Personalized SABT was an effective and safe alternative option for recurrent HNACC after the previous failure of surgery or EBRT. The parameter of D90 may influence the local control.
登录
查看更多内容
影响因子：
--
作者：
Rosenblatt E;Meushar N;Eidelman M;Kuten A
通讯作者：
Kuten A
影响因子：
1.9
作者：
Chen, Yi;Jiang, Yuliang;Wang, Junjie
通讯作者：
Wang, Junjie
影响因子：
2.6
作者：
Teudt, Ingo U.;Kovacs, Gyorgy;Meyer, Jens E.
通讯作者：
Meyer, Jens E.
影响因子：
1.4
作者：
Ji, Zhe;Sun, Haitao;Wang, Junjie
通讯作者：
Wang, Junjie
影响因子：
3.4
作者：
Wang, Jun Jie;Yuan, Hui Shu;Yang, Rui Jie
通讯作者：
Yang, Rui Jie