근접방사선조사에 의한 두경부암의 치료

Brachytherapy in the Treatment of Head and Neck Cancer

치료선량의 증가와 주위 정상조직의 보호의 의미에서 근접치료의 효과는 입증되어 있다. 그러나 우리 나라에서는 아직 통상치료법으로 상용화가 되어 있지 않다. 저자는 저선량률 이리디움 근접조사치료의 임상적 경험을 바탕으로 두경부암에서의 근접조사치료의 역사, 사용되는 동위원소의 재원 및 특성, 시행 시 고려 하여야할 사항, 임상기술적인 문제, 방사선물리학적 문제 등을 검토하였고 저자의 임상 경험 185례의 치료성적을 분석하여 그 효과를 검증하였고 마지막으로 향후 발전방향을 제시하여 보았다.

Brachytherapy has been proved to be an effective method for the purpose of increasing radiation dose to the tumor and reducing the dose to the surrounding normal tissue. In head and neck cancer, the rationale of brachytherapy is as follows; Firstly, early small lesion is radiocurative and the major cause of failure is local recurrence. Seondly, it can diminish evidently the dose to the normal tissue especially masseteric muscle and salivary gland. Thirdly, the anatomy of head and neck is suitable to various technique of brachytherapy. On background of accumulated experience of LDR iridium brachytherapy of head and neck cancer for the last 15 years, the author reviewed the history of radioisotope therapy, the characteristics of radionuclides, and some important things in the method, clinical technique and treatment planning. The author analyzed the clinical result of 185 cases of head and neck cancer treated in the Korea Cancer Center Hospital. Finally the future prospect of brachytherapy of head and neck cancer is discussed.