High-Dose Brachytherapy in Chemoradiation Schemes of Patients with Oral Mucosa Cancer

Abstract

The aim of the study was to improve clinical outcomes of oral mucosa cancer in case of surgical treatment failure.Materials and methods. A clinical case of combined radiation treatment of a patient with oral floor mucosa cancer St III T3N1M0 was presented. Pathogistological diagnosis # xxxxxx was: highly differentiated squamous cell carcinoma. A treatment plan was developed. Chemoradiotherapy at the first stage included 3 courses of intra-arterial chemotherapy (Selective (superselective) embolization (chemoembolization) of tumor vessels in the basin of the left and right facial and left lingual arteries, cisplatin 150 mg, combined with a daily infusion of 5-fluorouracil 4000 mg), with an interval 21 day. Chemoradiotherapy at the second stage included volume modulated arc therapy (VMAT) on the area of ​​the primary tumor (oral floor mucosa) and the regional metastasis pathways (total boost dose 60 Gy to the area of ​​regional lymph flow, otal boost dose 50 Gy to the oral cavity). Chemoradiotherapy at stage 3 included interstitial radiation therapy. A single boost dose (SBD) for the primary focus was 3 Gy/per fraction, 2 times a day, with an interval of 6 hours until total boost dose reached 21 Gy, 7 fractions.Results. After treatment, a complete regression of the tumor was noted. No pathological accumulation of radiopharmaceuticals, features of the tumor process was detected on PET/CT 48 months after treatment.Conclusions. Chemoradiotherapy combined with brachytherapy can be considered as an equal alternative to surgical treatment of patients with oral mucosa cancer.