Study on brachytherapy for elderly local advanced maxillofacial adenogenic malignancies based on biological target area

doi:10.19438/j.cjoms.2026.02.003

Abstract

Abstract: PURPOSE: To explore the application value of biological target volume(BTV) delineated by ¹⁸F-FDG PET-CT in brachytherapy for elderly patients with locally advanced maxillofacial adenogenic malignant tumors, and to compare the differences from gross tumor volume (GTV) delineated by contrast-enhanced CT and their impacts on treatment outcomes. METHODS: Eighteen elderly patients with maxillofacial adenogenic malignant tumors admitted to Xuzhou Central Hospital from June 2019 to June 2022 were enrolled. Preoperative ¹⁸F-FDG PET-CT and maxillofacial contrast-enhanced CT were performed, and imaging data were imported into the brachytherapy planning system(BTPS) to delineate BTV and GTV, respectively. The patients were randomly divided into the experimental group (implanted with ¹²⁵I seeds according to BTV) and the control group (implanted according to GTV). Target volume, postoperative dose distribution, short-term efficacy, and complications were compared between the two groups. RESULTS: The volume of BTV was (49.15±5.37) cm³, which was significantly smaller than that of GTV[(52.36±3.53) cm³](P<0.05). There were no significant differences in postoperative D₉₀, D₁₀₀, mean dose, and V₁₀₀ between the two groups(P>0.05). Within 12 months after surgery, the effective rates of the two groups were both 100%, and the clinical benefit rates were both 100%, with no significant difference(P>0.05). No grade 4 radiation reactions occurred in either group, and local symptoms were relieved after symptomatic treatment. CONCLUSIONS: The biological target volume delineated by ¹⁸F-FDG PET-CT can reduce the range of tumor target volume, alleviate radiation damage while ensuring target dose, and does not affect the treatment effect, providing a more precise target delineation method for brachytherapy of elderly patients with locally advanced maxillofacial adenogenic malignant tumors.

Key words: Maxillofacial region, Adenogenic malignant tumor, Brachytherapy, ¹⁸F-FDG PET-CT, Biological target volume, Target delineation

CLC Number:

R739.8

Ding Zixue, Zhuang Qianwei, Ge Liangyu, Xu Xinchen, Shao Cuiling, Meng Jian. Study on brachytherapy for elderly local advanced maxillofacial adenogenic malignancies based on biological target area[J]. China Journal of Oral and Maxillofacial Surgery, 2026, 24(2): 114-121.

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