Interstitial brachytherapy as boost for locally advanced T4 head and neck cancer
Interstitial brachytherapy as boost for locally advanced T4 head and neck cancer
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DOI：
10.1016/j.brachy.2009.03.191
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发表时间：
2009-10-01
期刊：
影响因子：
1.9
通讯作者：
Syed, Nisar
中科院分区：
文献类型：
--
作者：
Do, Ly;Puthawala, Ajmel;Syed, Nisar
目得：局部晚期头颈部鳞状细胞癌（SCCHN）伴骨和软骨浸润（BCI）或伴软组织浸润（STI）的患者已接受切除术+放化疗（CRT）或确定性CRT治疗。然而，局部复发仍然是治疗失败的一个重要组成部分。高剂量率间质性近距离放射治疗（BT）已用于剂量递增，以进一步防止局部复发。This is a review of our experience.METHODS AND MATERIALS：T4 NO-3 M0局部晚期口腔和口咽鳞状细胞癌（SCCA）患者接受了明确的CRT或放疗（RT）随访与近距离放射治疗（BT）。RT剂量范围为45 - 50.4戈伊。在该剂量下重新评估患者，如果反应不充分，则患者接受BT。BT剂量范围为24至30戈伊，每次3-4戈伊，BID，每次之间间隔6 h。结果：20例患者接受CRT或RT后BT治疗。13例患者接受STI治疗，7例患者接受BCI治疗; 14例患者接受CRT治疗，随后接受BT治疗; 6例患者接受单纯RT治疗，随后接受BT治疗。5年局部控制率为61%。5年总生存率为29%。当我们排除单独接受RT治疗的患者时，5年总生存率为36%。结的状态是唯一的预后factor.CONCLUSIONS：这项研究表明，CRT随访与BT的T4局部晚期SCCHN的口腔，口咽部的患者是一个可行的治疗选择。对于CRT反应较差的患者，BT可用于剂量递增，以增加局部控制。(c)2009年美国近距离放射治疗协会。爱思唯尔公司出版All rights reserved.
PURPOSE: Locally advanced squamous cell cancers of the head and neck (SCCHN) with bone and cartilage invasion (BCI) or those with soft-tissue invasion (STI) have been treated with resection followedup with chemoradiotherapy (CRT) or definitive CRT. However, locoregional recurrence remained a large component of treatment failure. High-dose-rate interstitial brachytherapy (BT) has been used for dose escalation to further prevent local relapse. This is a review of our experience.METHODS AND MATERIALS: T4NO-3M0 locally advanced oral cavity and oropharyngeal squamous cell carcinoma (SCCA) patients underwent definitive CRT or radiotherapy (RT) followedup with brachytherapy (BT). RT doses ranged from 45 to 50.4 Gy. The patients were reassessed at this dose and if response was inadequate, patients underwent BT. BT doses ranged from 24 to 30 Gy at 3-4 Gy per fraction BID with 6 h in between fractions. Concurrent chemotherapy was platinum based.RESULTS: Twenty patients were treated with CRT or RT alone followed by BT. Thirteen patients had STI and 7 had BCI; 14 patients were treated with CRT followed by BT; and 6 patients were treated with RT alone followed by BT. Five-year locoregional control was 61%. Five-year overall survival was 29%. When we excluded the patients treated with RT alone, 5-year overall survival was 36%. Nodal status was the only prognostic factor.CONCLUSIONS: This study suggests CRT followedup with BT for patients with T4 locally advanced SCCHN of the oral cavity, and oropharynx is a feasible treatment option. In patients with poor response to CRT, BT may be used for dose escalation to increase locoregional control. (c) 2009 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.