RESUMO
Concurrent chemoradiotherapy (CCRT) can be used in order to increase both the local and systemic control of head and neck carcinoma. This report shows for the first time the assessment of CCRT with S-1 as a treatment modality for squamous cell carcinoma (SCC) of the lower lip. Surgical excision is usually the first choice for the treatment of SCC of the lower lip, followed by reconstruction. Such a treatment choice more or less compromises the cosmetic and/or functional status of the lip. We present our experience of utilizing CCRT with S-1 as a mode of treatment for SCC of the lower lip that yielded significant results while preserving the integrity of the lip.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma de Células Escamosas/tratamento farmacológico , Carcinoma de Células Escamosas/radioterapia , Neoplasias Labiais/tratamento farmacológico , Neoplasias Labiais/radioterapia , Ácido Oxônico/uso terapêutico , Tegafur/uso terapêutico , Idoso , Carcinoma de Células Escamosas/patologia , Terapia Combinada , Combinação de Medicamentos , Feminino , Humanos , Neoplasias Labiais/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
PURPOSE: To reduce setup error and intrafractional movement in head-and-neck treatment, a real-time tumor tracking radiotherapy (RTRT) system was used with the aid of gold markers implanted in a mouthpiece. METHODS AND MATERIALS: Three 2-mm gold markers were implanted into a mouthpiece that had been custom made for each patient before the treatment planning process. Setup errors in the conventional immobilization system using the shell (manual setup) and in the RTRT system (RTRT setup) were compared. Eight patients with pharyngeal tumors were enrolled. RESULTS: The systematic setup errors were 1.8, 1.6, and 1.1 mm in the manual setup and 0.2, 0.3, and 0.3 mm in the RTRT setup in right-left, craniocaudal, and AP directions, respectively. Statistically significant differences were observed with respect to the variances in setup error (p <0.001). The systematic and random intrafractional errors were maintained within the ranges of 0.2-0.6 mm and 1.0-2.0 mm, respectively. The rotational systematic and random intrafractional errors were estimated to be 2.2-3.2 degrees and 1.5-1.6 degrees , respectively. CONCLUSIONS: The setup error and planning target volume margin can be significantly reduced using an RTRT system with a mouthpiece and three gold markers.
