Brachytherapy with 198Au grains for cancer of the floor of the mouth: relationships between radiation dose and complications

Konishi, Masaru; Takeuchi, Yuki; Imano, Nobuki; Kubo, Katsumaro; Nishibuchi, Ikuno; Murakami, Yuji; Shimabukuro, Kiichi; Wongratwanich, Pongsapak; Kakimoto, Naoya; Nagata, Yasushi

doi:10.1007/s11282-021-00532-8

Cited by 5 publications

(2 citation statements)

References 24 publications

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“…As brachytherapy for prostate cancer uses many radio-active sources, a dose reduction due to displacement of a few seeds may have insignificant influence on clinical outcome [ 14 ]. In contrast, as radio-active sources in 198 Au grain brachytherapy in oral cancers are arranged in proportion to the size and shape of the lesion [ 9 , 16 , 17 ], the treatment effect may vary when one grain deviates from the scheduled position or is displaced. This may lead to recurrence depending on the location or timing of the displaced grain.…”

Section: Discussionmentioning

confidence: 99%

Investigating the displacement of radio-active sources during gold-198 grain brachytherapy for hospitalized oral cancer patients

Konishi¹,

Takeuchi²,

Kubo³

et al. 2022

jcb

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Purpose This study aimed to investigate status of displacement of gold-198 ( 198 Au) grains in patients with oral cancers as well as factors and countermeasures for the displacement of 198 Au grains. Material and methods The present study included 34 patients with oral cancers, who were exclusively treated with 198 Au grain brachytherapy between 2013 and 2019. Timing and duration of the 198 Au grain displacement from the oral cavity and reduction in radiation dose were estimated. Location of the displaced grain was classified as either inside or outside of gross tumor volume. Number and location of the displacement of 198 Au grains, primary lesion, and growth type were evaluated. Results Of the 34 patients included in this study, 198 Au grains were displaced in 4 patients (11.8%) during hospitalization. A total of 5 grains (1.4%) were displaced out of an overall count of 367 grains implanted in these 34 patients. Of the four patients who experienced displacement of 198 Au grains, three had tongue cancer, and one had lip cancer. All four patients whose grains were displaced had superficial lesions. Conclusions When performing brachytherapy with 198 Au grains for superficial lesions on the tongue or lips, care should be taken to avoid grain displacement.

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Section: Discussionmentioning

confidence: 99%

Investigating the displacement of radio-active sources during gold-198 grain brachytherapy for hospitalized oral cancer patients

Konishi¹,

Takeuchi²,

Kubo³

et al. 2022

jcb

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“…In addition to the short half-life of radioactivity of the Au-198 grain (2.7 days), such noble metals are chemically stable and the surface of the grain is quite smooth, which allows permanent implantation to be possible. Although radiation-induced complications such as mucosal ulcer and bone exposure have been reported, there has been no previously reported grain entry into the submandibular gland after a long movement through Wharton's duct, as in this case [9,10]. We used Au-198 grains with radioactivity of 188 MBq per grain at the time of implantation.…”

Section: Discussionmentioning

confidence: 99%

Retrograde Migration of an Au-198 Grain to the Submandibular Gland Post Brachytherapy Treatment of Floor of Mouth Cancer

Nojima¹,

Kaida²,

Kuroshima³

et al. 2022

Cureus

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At our institution, radiation oncologists routinely treat early-stage oral cancer with low-dose-rate brachytherapy (LDR-BRT) using Au-198 grains. In this report, we show a unique case of a patient with a gold grain located within the submandibular gland, found incidentally during follow-up after LDR-BRT for floor of mouth cancer. One month after the implant, he showed sialadenitis-like symptoms, but the pain resolved two months later. All the grains were detected around the anterior sublingual area by computed tomography (CT) four months after the implant. Unexpectedly, 11 months after the implant, CT revealed that a grain was located in an intraglandular site of the submandibular gland. This finding clearly demonstrates that the grain entered Wharton's duct and retrogradely migrated to the submandibular gland through the duct. As a mechanism of the calculus formation within Wharton's duct, retrograde migration of foreign bodies to the inside of the duct has been proposed. Our incidental finding after LDR-BRT highlights the need for monitoring post-LDR-BRT using Au-198 grains for the treatment of floor of mouth cancer and sheds additional light on retrograde theory within Wharton's duct.

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A nomogram for predicting overall survival of patients with squamous cell carcinoma of the floor of the mouth: a population-based study

Cao

Liu

2023

Eur Arch Otorhinolaryngol

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Brachytherapy with 198Au grains for cancer of the floor of the mouth: relationships between radiation dose and complications

Cited by 5 publications

References 24 publications

Investigating the displacement of radio-active sources during gold-198 grain brachytherapy for hospitalized oral cancer patients

Investigating the displacement of radio-active sources during gold-198 grain brachytherapy for hospitalized oral cancer patients

Retrograde Migration of an Au-198 Grain to the Submandibular Gland Post Brachytherapy Treatment of Floor of Mouth Cancer

A nomogram for predicting overall survival of patients with squamous cell carcinoma of the floor of the mouth: a population-based study

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