Clinical uses of prosthetic devices in brachiotherapy for oral cavity tumors

Intraoral radiation stents-Primer for clinical use in head and neck cancer therapy

Intraoral radiation stents (IRS) are prosthetic devices that assist in the effective delivery of radiation to tumor tissues and aim to avoid unnecessary radiation to adjacent healthy tissues, thus limiting postradiotherapy toxicities. They are used to protect or displace vital structures, assist in positioning of the treatment beam for effective administration of radiotherapy, carry a radioactive material, shield healthy tissues of the oral cavity, and/or maintain the desired mouth opening during radiotherapy. With close collaboration between radiation oncologist and oral health care provider, several IRS can be fabricated by the latter for appropriate targeting and delivery of planned radiation dose and optimized treatment results. Modification of these IRS based on individual patient need is recommended to maximize prosthesis utility. The purpose of this review is to discuss the various types of IRS and highlight their clinical utility and benefits in patients receiving radiation therapy in the head and neck cancers.

Technique for construction of dental molds for high-dose-rate remote brachytherapy

High-dose-rate remote (HDR) brachytherapy eliminates radiation exposure hazard to personnel, allows for optimum dosage planning (dosimetry), and delivers high radiation dose close to the tumor in only a few minutes. The catheters can be incorporated into a fixed geometry within a mold, allowing for repeated treatments without the need for repeated implantation of radioactive isotopes or repeated dosimetry. This article presents the use of HDR brachytherapy in three patients to illustrate the advantages of HDR brachytherapy for the treatment of head and neck cancers in the following circumstances: (a) for outpatient therapy, (b) as an addition to or potentiation of external beam irradiation, (c) for preservation of function of regional structures, (d) for optimization of dosimetry, and (e) for palliation. It requires close interaction among the radiation oncologist, head and neck surgeon, and the dental oncologist and/or maxillofacial prosthodontist in order for optimum benefit for the patient to be achieved.

Afterloaded radiation carrier for carcinoma of the palate. A clinical report

Although every brachytherapy procedure is individualized, similar factors must be considered for each patient. Dental prostheses with modification may be useful in brachytherapy for managing selected patients with malignancies of the oral cavity. The prosthesis described in this article allowed an irregular surface to be treated with a relatively uniform radiation dose, while minimizing radiation exposure to uninvolved tissues and medical personnel. Whereas uniformity of dose is usually desirable in brachytherapy, it assumed even greater importance for this patient because of previous RT.