Intensity modulated perioperative HDR brachytherapy for recurrent and/or advanced head and neck metastases
Intensity modulated perioperative HDR brachytherapy for recurrent and/or advanced head and neck metastases
复制标题
DOI：
10.1007/s00405-015-3794-3
复制
发表时间：
2016-09-01
影响因子：
2.6
通讯作者：
Meyer, Jens E.
中科院分区：
文献类型：
--
作者：
Teudt, Ingo U.;Kovacs, Gyorgy;Meyer, Jens E.
头颈部鳞状细胞癌手术和全剂量辅助放疗后复发性颈部转移仍然是一个临床挑战。再次颈淋巴清扫术和化疗后，再照射剂量往往有限，生存预后恶化。在这里，辅助高剂量率调强围手术期近距离放射治疗（HDR IMBT）提供了第二个完整的辐射剂量与颈部正常组织辐射的有限体积。在这项回顾性研究中，确定了因复发性颈部转移而接受翻修手术和围手术期HDR IMBT的患者。估计了生存率，并回顾了关于颈部间质性近距离放射治疗的罕见文献。从2006年到2014年，9例患者接受了复发性或姑息性颈部转移瘤的挽救手术和HDR IMBT治疗。8例患者既往接受过手术和外照射放疗，伴或不伴化疗。2年和5年总生存率分别为78%和67%。HDR IMBT是手术翻修或最后一线治疗策略后选定颈部病例的挽救治疗选择。在文献和这个小队列中，辐射毒性和“颈动脉爆裂”的风险似乎很低。
Recurrent neck metastases following surgery and full dose adjuvant radiotherapy of squamous cell head and neck cancer remain a clinical challenge. After revision neck dissection and chemotherapy re-irradiation dosage is often limited and survival prognosis deteriorates. Here, adjuvant high-dose rate intensity modulated perioperative brachytherapy (HDR IMBT) offers a second full radiation dose with a limited volume of normal tissue radiation in the neck. In this retrospective study patients were identified who underwent revision surgery and perioperative HDR IMBT for recurrent neck metastases. Survival rates were estimated and the scarce literature on interstitial brachytherapy of the neck was reviewed. From 2006 to 2014, nine patients were treated for recurrent or palliative neck metastases using salvage surgery and HDR IMBT. Eight patients received previous surgery and external beam radiotherapy with or without chemotherapy. Two and five year overall survival was calculated to be 78 and 67 %, respectively. HDR IMBT is a salvage treatment option for selected cases in the neck following surgical revision or last-line treatment strategies. In the literature and this small cohort radiation toxicity and the risk of "carotid blow-out" seemed to be low.