GEC-ESTRO recommendations for brachytherapy for head and neck squamous cell carcinomas
GEC-ESTRO recommendations for brachytherapy for head and neck squamous cell carcinomas
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DOI：
10.1016/j.radonc.2009.01.005
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发表时间：
2009-05-01
影响因子：
5.7
通讯作者：
Strnad, Vratislav
中科院分区：
文献类型：
--
作者：
Mazeron, Jean-Jacques;Ardiet, Jean-Michel;Strnad, Vratislav
原发性和复发性头颈部鳞状细胞癌都是近距离放射治疗的经典适应症。通过良好的患者选择、细致的源植入和仔细的治疗计划，近距离放射治疗可以以有限的发病率为代价实现高的局部肿瘤控制率。然而，尚未进行随机试验，文献中缺乏证据，特别是关于头颈部亚部位近距离放射治疗的实际临床建议。因此，欧洲近距离放射治疗组（Groupe Europeen de Curietherapie-欧洲放射治疗和肿瘤学会（GEC-ESTRO））的头颈部工作组决定制定目前关于低剂量率、脉冲剂量率和高剂量率近距离放射治疗的共识建议。近距离放射治疗与外照射放射治疗和/或外科手术的结合使用也包括在内，以及在以前接受过放射治疗的患者中使用近距离放射治疗。鉴于文献中缺乏证据，这些建议主要基于工作组成员几十年来积累的临床经验和各自的出版物。建议的一般部分包括：（I）患者选择、治疗前检查和患者护理、（2）治疗策略、（3）靶点定义、（4）植入技术、（5）剂量和剂量率处方、（6）治疗计划和报告、（7）治疗监测、（8）导管移除和（9）治疗后患者护理和随访。然后，根据模拟的更集中的结构（患者选择、植入技术、靶点定义、剂量和剂量率处方、结果），为经典近距离放射治疗肿瘤部位指定建议：唇、口腔粘膜、移动的舌、口底、口咽、鼻咽、鼻窦。(C)2009爱思唯尔爱尔兰有限公司保留所有权利。放射治疗和肿瘤学91（2009）150 - 156
Both primary and recurrent squamous cell carcinoma of the head and neck are classic indications for brachytherapy. A high rate of local tumor control at the cost of limited morbidity can be achieved with brachytherapy through good patient selection, meticulous source implantation and careful treatment planning. However, no randomized trials have been performed, and there is scant evidence in the literature especially regarding practical clinical recommendations for brachytherapy for head and neck subsites. The Head and Neck Working Group of the European Brachytherapy Group (Groupe Europeen de Curietherapie-European Society for Therapeutic Radiology and Oncology (GEC-ESTRO) therefore decided to formulate the present consensus recommendations for low-dose rate, pulsed-dose rate and high-dose rate brachytherapy. The use of brachytherapy in combination with external beam radiotherapy and/or surgery is also covered as well as the use of brachytherapy in previously irradiated patients. Given the paucity of evidence in the literature, these recommendations are mainly based on clinical experience accumulated by the members of the working group over several decades and the respective publications. The recommendations cover in a general part (I) patient selection, the pre-treatment work up and patient care, (2) treatment strategy, (3) target definition, (4) implant techniques, (5) dose and dose rate prescription, (6) treatment planning and reporting, (7) treatment monitoring (8) catheter removal, and (9) post-treatment patient care and follow-up. The recommendations are then specified for the classical brachytherapy tumor sites following an analogue more focussed structure (patient selection, implant technique, target definition, dose and dose rate prescription, results): lip, oral mucosa, mobile tongue, floor of mouth, oropharynx, nasopharynx, paranasal sinuses. (C) 2009 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 91 (2009) 150-156