Acquisition of equal or better planning results with interstitial brachytherapy when compared with intensity-modulated radiotherapy in tongue cancers

Thogata, Ramanjappa; Raju, Alluri Krishnam; Muralidhar, KR; Sudarshan, G

doi:10.1016/j.brachy.2009.05.006

Cited by 15 publications

(13 citation statements)

References 7 publications

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“…reported that the ISBT treatment modality produces equal or superior planning results when compared with intensity-modulated radiation therapy (IMRT) [50]. Fifteen patients with tongue cancer treated with HDR-ISBT were replanned.…”

Section: Discussionmentioning

confidence: 99%

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High dose rate brachytherapy for oral cancer

Yamazaki

Yoshida

Yoshioka

et al. 2012

Journal of Radiation Research

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Brachytherapy results in better dose distribution compared with other treatments because of steep dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with brachytherapy as a sole treatment modality, a postoperative method, and a method of reirradiation. Low-dose-rate (LDR) brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR) brachytherapy has enabled health care providers to avoid radiation exposure. This therapy has been used for treating many types of cancer such as gynecological cancer, breast cancer, and prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for head and neck cancer. HDR brachytherapy has not become widely used in the radiotherapy community for treating head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR brachytherapy should be explored. To enhance the role of this therapy in treatment of head and neck lesions, we have reviewed its outcomes with oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR brachytherapy remains an important option for treatment of oral cancer.

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Section: Discussionmentioning

confidence: 99%

“…Planning time was also less in ISBT for many cases. These results encouraged the authors to continue ISBT [50]. They concluded that ISBT is an ideal solution for high-dose delivery exclusively to the primary tumor volume, while limiting the risks of severe xerostomia or trismus [1, 3, 6].…”

Section: Discussionmentioning

confidence: 99%

High dose rate brachytherapy for oral cancer

Yamazaki

Yoshida

Yoshioka

et al. 2012

Journal of Radiation Research

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“…Its lower cost and simplicity, coupled with its ability to provide high localized dose with rapid dose fall off has made it an excellent tool to provide conformal therapy in these cancers, with minimal side effects compared to EBRT. A study by Sresty et al ( 2010 ) showed that interstitial brachytherapy conferred more dose homogeneity when compared with IMRT and lesser dose to critical structures. Also planning time was much less for most cases.…”

Section: Discussionmentioning

confidence: 99%

Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa

et al. 2014

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BackgroundThe study aimed to assess the effect of High Dose Rate (HDR) Interstitial Brachytherapy when used alone or in combination with External Beam Radiotherapy (EBRT), in early and locally advanced squamous cell carcinoma of buccal mucosa.Materials and methodsThirty three patients with histologically proven squamous cell carcinoma of the buccal mucosa received high dose rate interstitial brachytherapy either as primary treatment or as a boost from November 2008 to April 2013. Stage I patients received interstitial brachytherapy alone to a dose of 38.50 Gy, 3.5 Gy per fraction, twice daily at six hours apart for 11 fractions. Stage II patients received EBRT to a dose of 50 Gy in 25 fractions of two Gy each followed by brachytherapy boost to 21 Gy, 3.5 Gy per fraction, twice daily at six hours apart for six fractions. Stage III patients received the same radiotherapy schedule (i.e., same EBRT & Brachytherapy schedule) and with addition of Injection Cisplatin 70 mg/m2 in three divided doses every three weeks along with EBRT.ResultsFollow up ranged from 12 to 60 months, median follow up was 26 months. Complete response was observed in 28 patients. Five patients had residual disease and were referred for surgical salvage. One patient died of disease progression. Stage I patients had 100% local control, whereas Stage II and Stage III patients had 84.6% and 80% local control respectively.ConclusionHDR Interstitial Brachytherapy used either as a primary treatment modality or as a boost in buccal mucosal cancers provides results comparable to that of surgery, with the advantages of organ preservation, better cosmetic and functional outcomes.

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“…Compared with the IMRT data, HDR brachytherapy in our study showed a better outcome, with a 3-year LCR of 84%. Sresty et al [ 13 ] compared IBT with IMRT with respect to treatment planning by designing and evaluating both in 15 patients with tongue cancer. They reported that IBT causes equal or superior planning results in regard to the conformity index and dose to critical organs.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer

et al. 2014

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PurposeTo evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer.Materials and MethodsSixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions.ResultsThe 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT ± external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (≤grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention.ConclusionHDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.

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Acquisition of equal or better planning results with interstitial brachytherapy when compared with intensity-modulated radiotherapy in tongue cancers

Cited by 15 publications

References 7 publications

High dose rate brachytherapy for oral cancer

High dose rate brachytherapy for oral cancer

Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa

Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer

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