Interstitial brachytherapy as boost for locally advanced T4 head and neck cancer

Do, Ly; Puthawala, Ajmel; Syed, Nisar

doi:10.1016/j.brachy.2009.03.191

Cited by 11 publications

(4 citation statements)

References 41 publications

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“…A retrospective study of local tumor excision followed by postoperative interstitial brachytherapy with and without external radiotherapy has shown excellent loco-regional control (33). In addition, brachytherapy can be delivered as an adjuvant “boost” to augment the radiation dose to a high risk area for advanced OSCC undergoing EBRT (34-37). An alternative approach is the use of simultaneous integrated boost IMRT but the relative value of both approaches remains to be determined.…”

Section: Interstitial Radiotherapy (Brachytherapy)mentioning

confidence: 99%

Oral cancer: Current role of radiotherapy and chemotherapy

Huang¹,

2013

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The term oral cavity cancer (OSCC) constitutes cancers of the mucosal surfaces of the lips, floor of mouth, oral tongue, buccal mucosa, lower and upper gingiva, hard palate and retromolar trigone. Treatment approaches for OSCC include single management with surgery, radiotherapy [external beam radiotherapy (EBRT) and/or brachytherapy], as well as adjuvant systemic therapy (chemotherapy and/or target agents); various combinations of these modalities may also be used depending on the disease presentation and pathological findings. The selection of sole or combined modality is based on various considerations that include disease control probability, the anticipated functional and cosmetic outcomes, tumor resectability, patient general condition, and availability of resources and expertise. For resectable OSCC, the mainstay of treatment is surgery, though same practitioners may advocate for the use of radiotherapy alone in selected “early” disease presentations or combined with chemotherapy in more locally advanced stage disease. In general, the latter is more commonly reserved for cases where surgery may be problematic. Thus, primary radiotherapy ± chemotherapy is usually reserved for patients unable to tolerate or who are otherwise unsuited for surgery. On the other hand, brachytherapy may be considered as a sole modality for early small primary tumor. It also has a role as an adjuvant to surgery in the setting of inadequate pathologically assessed resection margins, as does postoperative external beam radiotherapy ± chemotherapy, which is usually reserved for those with unfavorable pathological features. Brachytherapy can also be especially useful in the re-irradiation setting for persistent or recurrent disease or for a second primary arising within a previous radiation field. Biological agents targeting the epithelial growth factor receptor (EGFR) have emerged as a potential moda-lity in combination with radiotherapy or chemoradiotherpy and are currently under evaluation in clinical trials. Key words:Radiotherapy, chemoradiotherapy, oral cavity cancer, treatment.

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Section: Interstitial Radiotherapy (Brachytherapy)mentioning

confidence: 99%

Oral cancer: Current role of radiotherapy and chemotherapy

Huang¹,

2013

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“…reviewed their experience with patients with T4N0–3M0 locally advanced oral cavity and oropharyngeal squamous cell carcinoma who underwent definitive chemoradiotherapy or radiotherapy followed by HDR brachytherapy [44]. Radiotherapy doses ranged from 45–50.4 Gy.…”

Section: Introductionmentioning

confidence: 99%

“…The study of Do et al . [44] suggests that chemoradiotherapy followed by HDR brachytherapy is a feasible treatment option for patients with T4 locally advanced cancer of the oral cavity and oropharynx. In patients with poor response to chemoradiotherapy, HDR brachytherapy may be used for dose escalation to increase locoregional control.…”

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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“…The tumor approach through brachytherapy creates hope for unresectable cases, either primary brain tumors or metastases from other sites. 27,28 Iodine-125 brain brachytherapy has been recently reviewed. 30 The method provides encouraging survival rates with relatively low complication rates and good quality of life.…”

Section: Discussionmentioning

confidence: 99%