1
|
Murakami N, Sakuramachi M, Kashihara T, Chiba T, Nakamura S, Ono K, Ueno T, Yoshimoto S, Yoshida K, Masui K, Akiyama H, Igaki H. The combination of volumetric arc radiation therapy and boost high-dose rate interstitial brachytherapy for T3N2c tongue cancer: a technical report. Jpn J Clin Oncol 2023; 53:85-90. [PMID: 36239100 DOI: 10.1093/jjco/hyac160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 09/22/2022] [Indexed: 01/11/2023] Open
Abstract
Currently, tongue cancers are primarily managed by surgery, and interstitial brachytherapy is only recommended for a selected group of early state T1-2N0 patients who refuse surgery or are medically inoperable. In this report, a case with T3N2cM0 tongue cancer who has been effectively treated by the combination of concurrent chemoradiotherapy involving volumetric arc therapy and boost high-dose rate interstitial brachytherapy is presented. Of course, surgery remains the main treatment strategy for tongue cancer patients; however, the authors believe that if volumetric arc therapy is carefully planned to reduce the mandible dose as much as possible and high-dose rate interstitial brachytherapy with a mouthpiece that protects the mandible is combined, it is possible to treat T3N2 disease, and this can be considered for patients who want to preserve organ function.
Collapse
Affiliation(s)
- Naoya Murakami
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Madoka Sakuramachi
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Tairo Kashihara
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takahito Chiba
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Nakamura
- Radiation Safety and Quality Assurance Division, National Cancer Center Hospital, Tokyo, Japan
| | - Keisuke Ono
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Suidobashi Hospital, Tokyo, Japan
| | - Takao Ueno
- Department of Oral Health and Diagnostic Sciences, National Cancer Center Hospital, Tokyo, Japan
| | - Seiichi Yoshimoto
- Department of Head and Neck Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - Ken Yoshida
- Department of Radiology, Kansai Medical University, Osaka, Japan
| | - Koji Masui
- Department of Radiology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
| | - Hironori Akiyama
- Department of Oral Radiology, Osaka Dental University, Osaka, Japan
| | - Hiroshi Igaki
- Department of Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|
2
|
Jonovic K, Özcan M, Husain NAH, Mätzener KJ, Ciernik IF. Evaluation of radiodensity and dimensional stability of polymeric materials used for oral stents during external beam radiotherapy of head and neck carcinomas. Clin Transl Radiat Oncol 2022; 36:31-39. [PMID: 35762007 PMCID: PMC9233185 DOI: 10.1016/j.ctro.2022.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/28/2022] Open
Abstract
Purpose Intraoral stents protect the healthy tissues from ionizing radiation during external beam radiotherapy reducing mucositis, hyposalivation and osteoradionecrosis. This study investigated the radiodensity and dimensional stability of polymeric materials for suitability in construction of intraoral stents and aimed to provide clinical guidelines. Methods Specimens were fabricated using 4 material types namely, resin composite (ProTemp-PRO), polymethylmethacrylate (PMMA) (Enamel Temp Plus-ETP, Palapress-PAL, TAB 2000-TAB), polycaprolactone (Orfit-ORF) and silicone (Adisil-ADI, Lab Putty-LAB, Memosil2-MEM, Optosil-OPT, President Plus-PRE, Siolaplast A-SIA). They were randomly assigned to measure their radiodensity in Hounsfield Units (HU) (12x12x11mm3) (Nradiodensity = 66; n = 6) using a computer tomograph (CBCT, Toshiba Aquillon LB scanner) at baseline and after 6 weeks. The scanning protocol was applied with and without single energy metal artifact reduction (SEMAR) scans using a slice thickness of 1 and 5 mm. The same materials have been tested for their dimensional stability (µm3) at baseline, 1, 6, 12, 24 h, 3 and 6 weeks (14 × 4 × 2 mm3) (Ndimension = 55; n = 5 per material) using stereolithography (STL) files generated by a lab scanner (L2i, Imetric4D, Courgenay, Switzerland) and analyzed using a matching software (Geomagic ControlX 2020, 3D Systems). Data were analyzed using a paired t-test (alpha = 0.05). Results Radiodensity values (HU) were significantly affected by the material classification (p < 0.05). Polycaprolactone (43.6) presented significantly lower HU values followed by PMMA (91.3-414.9) than those of silicone materials (292.8-874.5). In terms of dimensional stability (µm3), PMMA materials (Δ:1.53-2.68) and resin composite (Δ:2.89) were significantly more dimensionally stable compared to those of silicone materials (Δ:13.64-6.63) and polycaprolactone (Δ:-0.76) and (p < 0.05). Conclusion For fabricating intraoral stents, when reduced radiodensity values are required polycaprolactone could be recommended as it fulfils the requirements for reduced radiodensity and dimensional stability. Among all silicone materials, OPT and MEM can be recommended based on the low HU and dimensional stability.
Collapse
Affiliation(s)
- Katarina Jonovic
- University of Zürich, Division of Dental Materials, Center for Dental and Oral Medicine, Zürich, Switzerland.,University of Zurich, School of Medicine and Dentistry, Medical Faculty, Zurich, Switzerland
| | - Mutlu Özcan
- University of Bern, School of Dental Medicine, Department of Reconstructive Dentistry and Gerodontology, Bern, Switzerland
| | - Nadin Al-Haj Husain
- University of Bern, School of Dental Medicine, Department of Reconstructive Dentistry and Gerodontology, Bern, Switzerland.,Radiation Oncology, Dessau City Hospital, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| | - Kiren Jan Mätzener
- University of Bern, School of Dental Medicine, Department of Reconstructive Dentistry and Gerodontology, Bern, Switzerland
| | - Ilja Frank Ciernik
- University of Zurich, School of Medicine and Dentistry, Medical Faculty, Zurich, Switzerland.,Radiation Oncology, Dessau City Hospital, Brandenburg Medical School Theodor Fontane, Dessau, Germany
| |
Collapse
|
3
|
Lim YJ, Kong M. Population-based comparative survival analysis of surgery with or without adjuvant radiotherapy and non-operative primary radiotherapy in patients with early-stage oral tongue squamous cell carcinoma. PLoS One 2021; 16:e0259384. [PMID: 34762670 PMCID: PMC8584751 DOI: 10.1371/journal.pone.0259384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 10/18/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Although recent clinical guidelines do allow primary radiotherapy for selected patients with early-stage oral tongue cancer, there has been little knowledge on the treatment outcomes of non-operative radiotherapy using modern treatment techniques. This study evaluated recent prognostic differences between primary radiotherapy and surgical resection in T1‒2N0 oral tongue squamous cell carcinoma. Methods Patients diagnosed with T1‒2N0 oral tongue squamous cell carcinoma were identified from the Surveillance, Epidemiology, and End Results database. After propensity score matching, the disease-specific survival of primary radiotherapy and surgery was compared. Results From a total of 8,458 patients initially identified, we defined matched cohorts: cohort A, comparing surgery alone vs. primary radiotherapy (n = 230 vs. 230), and cohort B, comparing surgery plus adjuvant radiotherapy vs. primary radiotherapy (n = 230 vs. 230). The 7-year disease-specific survival rates were 77% vs. 35% (cohort A) and 65% vs. 35% (cohort B) (P < 0.001 for all comparisons). Primary radiotherapy was independently associated with worse disease-specific survival in both cohorts A (hazard ratio 4.06; 95% confidence interval 2.53‒6.52) and B (hazard ratio 2.81; 95% confidence interval 1.96‒4.04). Time-course hazard rate function plots showed a distinct short-term risk increment in disease-specific mortality in the primary radiotherapy group. Conclusion In the contemporary treatment era, the use of radiotherapy as a definitive treatment resulted in an inferior prognosis in patients with T1‒2N0 oral tongue squamous cell carcinoma. The present population-based data suggest that primary radiotherapy cannot be used as an alternative to surgical management and it needs to be avoided as much as possible in early-stage tumors.
Collapse
Affiliation(s)
- Yu Jin Lim
- Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Moonkyoo Kong
- Department of Radiation Oncology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, South Korea
| |
Collapse
|
4
|
Suenaga H, Tamahara T, Dodo M, Murakami T, Sasaki S, Ito K, Jingu K, Koseki T, Sasaki K. Design of the spacer for brachytherapy using 198Au grain for carcinoma of the tongue as a tool of perioperative oral management. J Prosthodont Res 2018; 62:518-521. [DOI: 10.1016/j.jpor.2018.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/01/2018] [Accepted: 07/08/2018] [Indexed: 11/15/2022]
|
5
|
Ozaki Y, Watanabe H, Kaida A, Miura M, Nakagawa K, Toda K, Yoshimura R, Sumi Y, Kurabayashi T. Estimation of whole-body radiation exposure from brachytherapy for oral cancer using a Monte Carlo simulation. JOURNAL OF RADIATION RESEARCH 2017; 58:523-528. [PMID: 28339846 PMCID: PMC5570130 DOI: 10.1093/jrr/rrx002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 08/23/2016] [Accepted: 12/18/2016] [Indexed: 06/06/2023]
Abstract
Early stage oral cancer can be cured with oral brachytherapy, but whole-body radiation exposure status has not been previously studied. Recently, the International Commission on Radiological Protection Committee (ICRP) recommended the use of ICRP phantoms to estimate radiation exposure from external and internal radiation sources. In this study, we used a Monte Carlo simulation with ICRP phantoms to estimate whole-body exposure from oral brachytherapy. We used a Particle and Heavy Ion Transport code System (PHITS) to model oral brachytherapy with 192Ir hairpins and 198Au grains and to perform a Monte Carlo simulation on the ICRP adult reference computational phantoms. To confirm the simulations, we also computed local dose distributions from these small sources, and compared them with the results from Oncentra manual Low Dose Rate Treatment Planning (mLDR) software which is used in day-to-day clinical practice. We successfully obtained data on absorbed dose for each organ in males and females. Sex-averaged equivalent doses were 0.547 and 0.710 Sv with 192Ir hairpins and 198Au grains, respectively. Simulation with PHITS was reliable when compared with an alternative computational technique using mLDR software. We concluded that the absorbed dose for each organ and whole-body exposure from oral brachytherapy can be estimated with Monte Carlo simulation using PHITS on ICRP reference phantoms. Effective doses for patients with oral cancer were obtained.
Collapse
Affiliation(s)
- Y. Ozaki
- Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - H. Watanabe
- Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - A. Kaida
- Department of Oral Radiation Oncology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - M. Miura
- Department of Oral Radiation Oncology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - K. Nakagawa
- Department of Radiation Therapeutics and Oncology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - K. Toda
- Department of Radiation Therapeutics and Oncology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - R. Yoshimura
- Department of Radiation Therapeutics and Oncology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan
| | - Y. Sumi
- Center of Advanced Medicine for Dental and Oral Diseases, National Center for Geriatrics and Gerontology, Moriokacho 7-430, Obu-shi, Aichi, Obu, 474-8511, Japan
| | - T. Kurabayashi
- Department of Oral and Maxillofacial Radiology, Graduate School, Tokyo Medical and Dental University, Yushima 1-5-45, Bunkyo-ku, Tokyo, 113-8549, Japan
| |
Collapse
|
6
|
Kaida A, Watanabe H, Toda K, Yuasa-Nakagawa K, Yoshimura R, Miura M. Effects of dose rate on early and late complications in low dose rate brachytherapy for mobile tongue carcinoma using 192Ir sources. Oral Radiol 2016. [DOI: 10.1007/s11282-016-0263-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
7
|
Preventing Complications from High-Dose Rate Brachytherapy when Treating Mobile Tongue Cancer via the Application of a Modular Lead-Lined Spacer. PLoS One 2016; 11:e0154226. [PMID: 27128434 PMCID: PMC4851388 DOI: 10.1371/journal.pone.0154226] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 04/11/2016] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To point out the advantages and drawbacks of high-dose rate brachytherapy in the treatment of mobile tongue cancer and indicate the clinical importance of modular lead-lined spacers when applying this technique to patients. METHODS First, all basic steps to construct the modular spacer are shown. Second, we simulate and evaluate the dose rate reduction for a wide range of spacer configurations. RESULTS With increasing distance to the source absorbed doses dropped considerably. Significantly more shielding was obtained when lead was added to the spacer and this effect was most pronounced on shorter (i.e. more clinically relevant) distances to the source. CONCLUSIONS The modular spacer represents an important addition to the planning and treatment stages of mobile tongue cancer using HDR-ISBT.
Collapse
|
8
|
High-dose-rate interstitial brachytherapy in early stage oral tongue cancer - 15 year experience from a tertiary care institute. J Contemp Brachytherapy 2016; 8:56-65. [PMID: 26985198 PMCID: PMC4793073 DOI: 10.5114/jcb.2016.58082] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Accepted: 01/11/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose To determine outcomes of interstitial high-dose-rate brachytherapy (HDR-BT) in patients with early stage oral tongue cancer. Material and methods Ninety-two patients with stage I and II oral tongue cancer were treated with HDR-BT between 1999 and 2014: brachytherapy alone = 62 (67.4%), and combination of external beam radiotherapy (EBRT) and brachytherapy = 30 (32.6%). Median follow-up was 53.5 months. Patterns of failure, overall survival (OS), disease-free survival (DFS), local control rates (LCR), and nodal control rates (NCR) were determined. Results 5-year OS, DFS, LCR, and NCR were 73.2%, 58.2%, 64.2%, and 83.8%, respectively. In total, 43 patients (46.7%) failed treatment: isolated local failures = 28 (30.4%), isolated nodal failures = 8 (8.7%), both local and regional failures = 7 (7.6%). While in T1 stage, 5 year LCR were significantly higher in brachytherapy alone group compared to combined EBRT and brachytherapy group (81.7% vs. 62.5%, p = 0.04), the isolated nodal failure rates were not significantly different among the two groups. For T2 stage, NCR were higher in combined EBRT and brachytherapy group compared to brachytherapy alone (92.9% vs. 74.3%). Acute mucositis (grade ≥ 2) was seen more in brachytherapy alone group compared to the combined modality group (87% vs. 66%), and this correlated significantly with the higher biological equivalent dose (BED) in the brachytherapy alone group. Conclusions Our study recommends treating patients with brachytherapy alone in T1 stage, and demonstrates the need for addressing nodal region either by neck dissection or nodal irradiation in T2 stage patients. Also, the study highlights the need for dose escalation (from the doses used in the study) in both T1 and T2 stage tumors when using interstitial brachytherapy either as sole modality or as a boost.
Collapse
|
9
|
Ryu Y, Shibuya H, Hayashi K. 198Au grain implantation for early tongue cancer in patients of advanced age or poor performance status. JOURNAL OF RADIATION RESEARCH 2013; 54:1125-1130. [PMID: 23685669 PMCID: PMC3823781 DOI: 10.1093/jrr/rrt060] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 04/11/2013] [Accepted: 04/11/2013] [Indexed: 06/02/2023]
Abstract
Brachytherapy using (198)Au grains is minimally invasive and the only curative treatment for early tongue cancer in patients of advanced age or poor performance status available in our institution. From March 1993 to February 2008, (198)Au grains were used to treat a group of 96 Stage I-II tongue cancer patients who could not undergo surgery or brachytherapy using (192)Ir pins because of an advanced age (≥75 years) or poor performance status (≥2). The patients were followed for 3.9 ± 3.3 years, and the cause-specific survival and local control rates were determined. Survival analyses were performed using the Kaplan-Meier method, and univariate and multivariate analyses were performed using the Cox proportional hazard model. The results were compared with those for a group of 193 early tongue-cancer patients who underwent treatment using iridium pins. The 5-year cause-specific survival and local control rates of the (198)Au grains group were 71% and 68%, respectively, both of which were 16% lower than the corresponding rates for the (192)Ir pins group. Our study demonstrated that as the last curative treatment available, (198)Au grain implantation could be used to achieve moderate treatment results for early tongue cancer in patients of advanced age or poor performance status.
Collapse
Affiliation(s)
- Yoshiharu Ryu
- Corresponding author. Department of Radiology, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan. Tel: +81-3-5803-5311; Fax: +81-3-3980-2991;
| | | | | |
Collapse
|
10
|
Sultana J, Bashar A, Molla MR. New Management Strategies of Oral Tongue Cancer in Bangladesh. J Maxillofac Oral Surg 2013. [PMID: 26225002 DOI: 10.1007/s12663-013-0566-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Malignancies of the tongue represent one of the greatest management challenges for the maxillofacial surgeons as well as oncologists, because of the adverse effects of treatment on oral and pharyngeal function, the eventual quality of life, and the poor prognosis of advanced disease. Therefore, it is important to use judgment and experience in determining the best method of treatment. MATERIAL AND METHODS We reviewed forty cases of oral tongue cancer patients admitted in the Dental and Facio-Maxillary Surgical Oncology department in National Institute of Cancer Research and Hospital, and department of Oral and Maxillofacial Surgery, Dhaka Dental College and Hospital, Dhaka, Bangladesh, during the past four years and followed till the lesion healed or recurred and followed later on upto two years. All cases were thoroughly examined, investigated with routine blood examinations and radiography of the involved region. Preoperative biopsy of the lesion and staging was done in each and every case. Postoperative biopsy was taken where there was a doubt about the possibility of recurrence. RESULTS Squamous cell carcinoma (well differentiated) is by far the most common malignancy of the oral tongue. Generally a correlation is recognized between tumor size, nodal presence, metastasis, and eventual prognosis. When surgeons detect oral tongue cancer at an early stage, they can often treat it with surgery or can, often treat it with surgery or radiation. In later stages the cancer may require a combination of surgery, radiation and chemotherapy. CONCLUSION Standard and uniform protocol has not been explored till now for the practice in our country. So current management strategies of oral tongue cancer cannot be underestimated.
Collapse
Affiliation(s)
- Jachmen Sultana
- Department of Oral and Maxillofacial Surgery, Dhaka Dental College and Hospital, Dhaka, Bangladesh ; Elysia, House # 24, Flat # A-2, Road # 6, Dhanmondi, Dhaka, 1205 Bangladesh
| | - Abul Bashar
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Motiur Rahman Molla
- Department of Oral and Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| |
Collapse
|
11
|
Khalilur R, Hayashi K, Shibuya H. Brachytherapy for tongue cancer in the very elderly is an alternative to external beam radiation. Br J Radiol 2010; 84:747-9. [PMID: 20682593 DOI: 10.1259/bjr/23130739] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The result of curative treatment for very elderly patients with tongue carcinoma has not been reported to date. We retrospectively reviewed the results of brachytherapy in 125 the patients aged over 75 years. METHODS The results of brachytherapy in 125 patients, 75 years old or older, with Stage I or II squamous cell carcinoma of the oral tongue were reviewed. The 125 cases consisted of 31 Stage I and 94 Stage II cases; 67 patients were under 80 years old and 58 were over 80 years old. All patients were treated using low-dose-rate brachytherapy ((198)Au/(222)Rn: 59 cases; (192)Ir: 38 cases; (226)Ra/(137)Cs: 28 cases). RESULTS None of the patients stopped treatment during the course of brachytherapy. The 3 year and 5 year control rates of the primary lesions were both 86%. Post-brachytherapy neck node metastasis was diagnosed in 43 cases and radical neck dissection was performed for 24 cases (21 of the 24 cases were under 80 years old). As a result, the 7 year disease-specific survival (DSS) rate for patients aged under 80 years old was 70% and 41% for those over 80 years old (p = 0.03). CONCLUSION The brachytherapy for elderly patients with tongue cancer was safe, and the control of the primary lesion was almost the same as in younger patients. However, modalities available to treat neck node metastasis are limited. More conservative surgical approaches combined with post-operative irradiation may be advocated for neck node metastasis for elderly patients with tongue cancer.
Collapse
Affiliation(s)
- R Khalilur
- Department of Radiology, Tokyo Medical and Dental University, 5-45, Yushima 1-chome, Bunkyo-ku, Tokyo 113-8519, Japan
| | | | | |
Collapse
|
12
|
Guinot JL, Santos M, Tortajada MI, Carrascosa M, Estellés E, Vendrell JB, Muelas R, Chust ML, Mengual JL, Arribas L. Efficacy of high-dose-rate interstitial brachytherapy in patients with oral tongue carcinoma. Brachytherapy 2010; 9:227-34. [PMID: 20116340 DOI: 10.1016/j.brachy.2009.10.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2009] [Revised: 09/20/2009] [Accepted: 10/16/2009] [Indexed: 11/24/2022]
|
13
|
Shibuya H. Current status and perspectives of brachytherapy for head and neck cancer. Int J Clin Oncol 2009; 14:2-6. [PMID: 19225918 DOI: 10.1007/s10147-008-0859-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2008] [Indexed: 11/29/2022]
Abstract
Brachytherapy delivers a high radiation dose to a limited volume while sparing surrounding normal tissues. In head and neck cancer, severe soft-tissue damage and bone damage to the mandible has decreased markedly since the introduction of computer dosimetry and the use of spacers during treatment. For the curative treatment of head and neck cancer, the selection of brachytherapy sources from among the several linear and small permanent implant sources available, not only according to the tumor site but also according to the patient's physical and mental condition is important. Following the successful treatment of early head and neck cancer by brachytherapy, two major problems and one minor problem may confront the physician. The major problems are neck node metastasis and a second primary cancer of the respiratory tract or upper digestive tract, and the minor problem is radiation-induced cancer.
Collapse
Affiliation(s)
- Hitoshi Shibuya
- Department of Radiology, Tokyo Medical and Dental University Hospital, Tokyo, Japan.
| |
Collapse
|