目的:分析舌癌(TC)患者围手术期间质近距离放射治疗(ISBT)的疗效。
方法:2009年4月至2015年5月,连续43例确诊为TC的鳞状细胞癌患者行有限部分舌叶切除术和围手术期ISBT治疗,使用高剂量率(HDR)。27例患者接受近距离放射治疗(BT),淋巴结清扫结果后,16人接受了BT作为后续外束放射治疗(EBRT)的补充。年龄中位数为66岁。按阶段分配,包括10名I期患者,14阶段II,10第三阶段,第9阶段IV。18例患者切缘阴性,十九点保证金参与,在六种情况下,边缘<5毫米。
结果:中位随访时间为54个月,3年和5年的LC分别为87%和84%,分别。在有清晰边缘的患者中,5年的LC为95%,75%的利润率。在接受BT治疗的N0患者中,5年的LC为83%,在接受后路EBRT治疗的N+患者中,LC为86%。根据肿瘤大小,我们发现13例T1局部复发,27例T2中有5例局部复发,和没有局部复发T3与87%的LC,70%,五年分别为100%。3年和5年的区域控制率(RC)为81%。我们发现3年和5年无转移生存率为91%。23个病人已经死亡,其中11个是由于其他原因,3年总生存率为56%,5年总生存率为53%。
结论:保守性手术和ISBT联合治疗显示与根治性手术或单纯放疗相似的结果。允许更适合患者的方法,具有良好的器官功能保存和美容效果。
UNASSIGNED: To analyze the results of patients treated with perioperative interstitial brachytherapy (ISBT) in tongue carcinoma (TC).
UNASSIGNED: From April 2009 to May 2015, 43 squamous cell carcinoma consecutive patients diagnosed with TC were treated with limited partial glossectomy and perioperative ISBT, using high-dose-rate (HDR). Twenty- seven patients were treated by brachytherapy (BT), and sixteen received BT as a complement to subsequent external beam radiotherapy (EBRT) after results of lymph node dissection. Median age was 66 years. Distribution by stage, included 10 patients stage I, 14 stage II, 10 stage III, and 9 stage IV. Eighteen patients had negative margins, nineteen margin involvement, and in six cases, the margin was < 5 mm.
UNASSIGNED: With a median follow-up of 54 months, LC at 3 and 5 years was 87% and 84%, respectively. LC was 95% at five years in patients with clear margins, and 75% with involved margins. LC in N0 patients treated with BT was 83% at 5 years, and in patients N+ with posterior EBRT treatment, LC was 86%. By tumor size, we found one local relapse in 13 cases T1, in 5 of 27 patients T2 was found, and no local relapse T3 with LC of 87%, 70%, and 100% respectively at five years. Regional control (RC) was 81% at 3 and 5 years. We found a metastasis-free survival of 91% at 3- and 5-year. Twenty-three patients have died, 11 of them due to other causes, with overall survival of 56% at three years and 53% at five years.
UNASSIGNED: Combined treatment with conservative surgery and ISBT shows similar results to radical surgery or RT alone, allowing a more patient-tailored approach, with good organ function preservation and cosmetic outcomes.