Per-oral interstitial brachytherapy catheter insertion for boost in case of recurrent tonsillar carcinoma: dosimetry and clinical outcome

High-dose-rate interstitial brachytherapy (HDR-ISBT) is relatively rarely applied for the head and neck cancer. However, its dose distribution is more confined than intensity modulated radiation therapy (IMRT) and can deliver higher dose while sparing surrounding normal tissues. In this case report, the effectiveness of HDR-ISBT as a boost following IMRT for post-operative recurrent oropharyngeal cancer patient was indicated. A 73-year-old male who developed local recurrence after surgery for oropharyngeal squamous cell carcinoma. Salvage IMRT up to 70 Gy concurrent with weekly cetuximab was planned. However, CT taken at 60 Gy found a residual tumor, then, boost HDR-ISBT was proposed. 1 week after 60 Gy of IMRT, HDR-ISBT, 12 Gy in 2 fractions, was delivered under local anesthesia. MRI taken 2 months after HDR-ISBT showed no residual tumor. It was demonstrated that boost HDR-ISBT following IMRT for local recurrence of oropharyngeal cancer was performed safely and showed favorable efficacy.

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Treatment Planning Methods in High Dose Rate Interstitial Brachytherapy of Carcinoma Cervix: A Dosimetric and Radiobiological Analysis

ISRN Oncology ◽

10.1155/2014/125020 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Surega Anbumani ◽

Pichandi Anchineyan ◽

ArunaiNambiraj Narayanasamy ◽

Siddanna R. Palled ◽

Sajitha Sathisan ◽

...

Keyword(s):

Dose Rate ◽

Treatment Planning ◽

High Dose Rate ◽

Optimization Techniques ◽

Interstitial Brachytherapy ◽

Tumor Control ◽

High Dose ◽

Tumor Control Probability ◽

Normal Tissues ◽

Planning Methods

Treatment planning is a trial and error process that determines optimal dwell times, dose distribution, and loading pattern for high dose rate brachytherapy. Planning systems offer a number of dose calculation methods to either normalize or optimize the radiation dose. Each method has its own characteristics for achieving therapeutic dose to mitigate cancer growth without harming contiguous normal tissues. Our aim is to propose the best suited method for planning interstitial brachytherapy. 40 cervical cancer patients were randomly selected and 5 planning methods were iterated. Graphical optimization was compared with implant geometry and dose point normalization/optimization techniques using dosimetrical and radiobiological plan quality indices retrospectively. Mean tumor control probability was similar in all the methods with no statistical significance. Mean normal tissue complication probability for bladder and rectum is 0.3252 and 0.3126 (P=0.0001), respectively, in graphical optimized plans compared to other methods. There was no significant correlation found between Conformity Index and tumor control probability when the plans were ranked according to Pearson product moment method (r=-0.120). Graphical optimization can result in maximum sparing of normal tissues.

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