Experience of high-dose-rate brachytherapy for head and neck cancer treated by a customized intraoral mold technique

Obinata, Kenichi; Ohmori, Keiichi; Shirato, Hiroki; Nakamura, Motoyasu

doi:10.1007/s11604-007-0121-y

Cited by 24 publications

(12 citation statements)

References 14 publications

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“…presented a report of their clinical experience with HDR brachytherapy for head and neck cancer using a customized intraoral mold technique [38]. Two patients were treated with dental prostheses as the radiation carriers for HDR brachytherapy of head and neck cancer.…”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

High dose rate brachytherapy for oral cancer

Yamazaki

Yoshida

Yoshioka

et al. 2012

Journal of Radiation Research

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“…125 I has physical characteristics of low dosage rates, low photon energy (averagely 28 keV), and short effective penetration distance in the tissue (1.7 cm in soft tissue), so the doses to the surrounding normal tissues decrease very rapidly with distance, and are easily confined within the tumor target. Thus the image-guidance 125 I seed permanent implantation which allows the application of a high radiation dose while avoiding severe adverse events can be applied to patients who are of advanced age with poor performance status or who have complications, thereby improving the prognosis of our patients [14]. …”

Section: Discussionmentioning

confidence: 99%

<sup>125</sup>I Seed Permanent Implantation as a Palliative Treatment for Stage III and IV Hypopharyngeal Carcinoma

Li¹,

Yang²,

Li³

et al. 2016

Clin Exp Otorhinolaryngol

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Objectives.The aim of this study was to investigate the feasibility and safety of percutaneous 125I seed permanent implantation for advanced hypopharyngeal carcinoma from toxicity, tumor response, and short-term outcome.Methods.125I seeds implant procedures were performed under computed tomography for 34 patients with advanced hypopharyngeal carcinoma. We observed the local control rate, overall survival, and acute or late toxicity rate.Results.In the 34 patients (stage III, n=6; stage IV, n=28), the sites of origin were pyriform sinus (n=29) and postcricoid area (n=5). All patients also received one to four cycles of chemotherapy after seed implantation. The post-plan showed that the actuarial D90 of 125I seeds ranged from 90 to 158 Gy (median, 127 Gy). The mean follow-up was 12.3 months (range, 3.4 to 43.2 months). The local control was 2.1–31.0 months with a median of 17.7 months (95% confidence interval [CI], 13.4 to 22.0 months). The 1-, 2-, and 3-year local controls were 65.3%, 28.6%, and 9.5% respectively. Twelve patients (35%) died of local recurrence, fourteen patients (41%) died of distant metastases, and three patients (9%) died of recurrence and metastases at the same time. Five patients (15%) still survived to follow-up. At the time of analysis, the median survival time was 12.5 months (95% CI, 9.5 to 15.4 months). The 1-, 2-, and 3-year overall survival rates were 55.2%, 20.3%, and 10.9%, respectively. Five patients (15%) experienced grade 3 toxic events and nine patients (26%) have experienced grade 2 toxic events.Conclusion.This review shows relatively low toxicity for interstitial 125I seed implantation in the patients with advanced stage hypopharyngeal cancer. The high local control results suggest that 125I seed brachytherapy implant as a salvage or palliative treatment for advanced hypopharyngeal carcinoma merit further investigation.

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“…[6][7][8] There has been increased interest in the use of customized intraoral mold HDR brachytherapy for oral malignancies. [9][10][11][12] This provides an additional option for patients with superficial oral cavity cancers that can be used as monotherapy or boost. It is particularly suitable for elderly patients because of the noninvasive nature, shorter treatment, and low toxicity profile.…”

Section: Discussionmentioning

confidence: 99%