High-dose-rate brachytherapy using molds for oral cavity cancer: The technique and its limitations
High-dose-rate brachytherapy using molds for oral cavity cancer: The technique and its limitations
复制标题
使用口腔癌模具进行高剂量率近距离放射治疗：该技术及其局限性
DOI：
10.1007/bf00539212
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发表时间：
1998
影响因子：
3.3
通讯作者：
M. Hiraoka
中科院分区：
文献类型：
--
作者：
Y. Nishimura;Y. Nishimura;Y. Yokoe;Y. Nagata;K. Okajima;M. Nishida;M. Hiraoka
背景：随着高剂量率（HDR）远程后装装置的可用性，在我们的机构启动了I/11期方案，以评估HDR腔内近距离放射治疗的毒性和有效性，使用模具，在口腔鳞状细胞癌的治疗中。肿瘤的原发部位是颊粘膜、口底和牙龈。两个颊粘膜癌位于磨牙后三角区。对于每个患者，制造定制模具，其中放置两到四个后装导管用于192 Ir HDR源。外照射剂量为40-60戈伊/2戈伊，在模具表面以下5 mm处照射4 ~ 7次，每次3-4戈伊。HDR近距离放射治疗的总剂量范围为16 ~ 28戈伊。结果：虽然7/8（88%）的初始完全缓解率良好，但这7例患者中有4例局部复发。磨牙后三角区肿瘤均出现边缘复发。不严重（例如，溃疡或骨暴露）晚期放射损伤已观察到迄今在随访期15-57 months.Conclusions.高剂量率近距离放射治疗使用模具技术似乎是一个安全和有用的方法选择早期和浅表口腔癌。然而，它不适用于厚肿瘤和/或位于磨牙后三角区的肿瘤。
Background.With the availability of a high-dose-rate (HDR) remote afterloading device, a Phase I/11 protocol was initiated at our institution to assess the toxicity and efficacy of HDR intracavitary brachytherapy, using molds, in the treatment of squamous cell carcinomas of the oral cavity.Methods.Eight patients with squamous cell carcinoma of the oral cavity were treated by the technique. The primary sites of the tumors were the buccal mucosa, oral floor, and gingiva. Two of the buccal mucosal cancers were located in the retromolar trigon. For each patient, a customized mould was fabricated, in which two to four afterloading catheters were placed for an192Ir HDR source. Four to seven fractions of 3–4 Gy, 5 mm below the mould surface, were given following external radiation therapy of 40–60 Gy/2 Gy. The total dose of HDR brachytherapy ranged from 16 to 28 Gy.Results.Although a good initial complete response rate of 7/8 (88%) was achieved, there was local recurrence in four of these seven patients. Both of the retromolar trigon tumors showed marginal recurrence. No serious (e.g., ulcer or bone exposure) late radiation damage has been observed thus far in the follow up period of 15–57 months.Conclusions.High-dose-rate brachytherapy using the mold technique seems a safe and useful method for selected early and superficial oral cavity cancer. However, it is not indicated for thick tumors and/or tumors located in the retromolar trigon.