The role of interstitial brachytherapy in the treatment of vaginal and vulvar malignancies
The role of interstitial brachytherapy in the treatment of vaginal and vulvar malignancies
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DOI：
10.1007/s00066-006-1461-8
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发表时间：
2006-03-01
影响因子：
3.1
通讯作者：
Strnad, V
中科院分区：
文献类型：
--
作者：
Seeger, AR;Windschall, A;Strnad, V
背景：辐射已成为外阴和阴道恶性肿瘤的治疗方法。由于外阴和阴道组织的敏感性，间质近距离放射治疗 (iBT) 提供了一种有效、温和且个性化的治疗。 患者和方法：使用间质脉冲剂量率近距离放射治疗 (PDR-iBT) 治疗外阴（22 例中的 9 例）和阴道（22 例中的 13 例）恶性肿瘤患者。 22 名患者中有 12 名另外接受了骨盆和区域淋巴结的外照射治疗。给予外阴癌患者的 PDR-iBT 中位总剂量为 55.0 Gy。阴道恶性肿瘤患者接受的中位 PDR 总剂量为 20.25 Gy。 结果：外阴癌患者的中位随访时间为 19 个月，阴道恶性肿瘤患者的中位随访时间为 27 个月。 22 名患者中有 15 名在 iBT 期间观察到急性粘膜炎或皮肤反应。 22 名患者中有两名出现迟发性副作用。 6个月后，77.8%的外阴癌患者（9人中的7人）和100%的阴道恶性肿瘤患者（13人中的13人）实现局部完全缓解。九名外阴癌患者中有一名出现局部复发，九名患者中有四名出现区域复发，九名患者中有两名出现区域复发并在治疗后出现局部肿瘤。在阴道恶性肿瘤患者中，未观察到局部复发病例，但 13 名患者中有 5 名发现远处转移。截至分析时，22 名外阴癌或阴道癌患者中有 11 名仍然活着。结论：IBT 取得了良好的局部控制，在两个部位均未出现严重的迟发副作用。然而，生存受到区域或远处转移的限制。
Background: Irradiation has established itself as a treatment for vulvar and vaginal malignancies. Due to the sensitive nature of the vulvar and vaginal tissues, interstitial brachytherapy (iBT) provides an effective, gentle and individualized therapy.Patients and Methods: Patients with vulvar (nine of 22) and vaginal (13 of 22) malignancies were treated using interstitial pulsed-dose-rate brachytherapy (PDR-iBT). Twelve out of 22 patients were additionally treated using external-beam therapy to the pelvis and regional Lymph nodes. The median total dose of PDR-iBT administered to patients with vulvar carcinoma was 55.0 Gy. The median total PDR dose administered to patients with vaginal malignancies amounted to 20.25 Gy.Results: The median follow-up time for patients with vulvar cancer was 19 months and for patients with vaginal malignancies 27 months. Acute mucositis or skin reactions during iBT were observed in 15 of 22 patients. Two of 22 patients showed delayed side effects. After 6 months, 77.8% of the patients with vulvar cancer (seven out of nine) and 100% of the patients with vaginal malignancies (13 out of 13) achieved complete Local remission. One patient out of nine with vulvar carcinoma developed Local recurrence, four out of nine regional recurrence, and two out of nine developed regional recurrence and had Local tumor following therapy. In patients with malignancies of the vagina, no cases of Local recurrence were observed, but distant metastases were found in five out of 13 patients. At the time of analysis, eleven out of 22 patients with vulvar or vaginal carcinoma were still alive.Conclusion: IBT achieved good Local control without serious delayed side effects in both localizations. However, survival is limited by regional or distant metastases.