Radiant advances: The future of brachytherapy in oral oncology

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Abstract

Brachytherapy has become integral to the treatment of oral cancers, offering the advantage of delivering high doses of radiation directly to tumors while minimizing exposure to surrounding healthy tissues. This review examines recent advancements that have significantly improved the precision and effectiveness of brachytherapy. The integration of high-resolution imaging technologies, such as MRI and CT scans, has enhanced tumor delineation, enabling more accurate placement of radioactive sources. Innovations in radioactive sources, particularly high-dose-rate (HDR) brachytherapy, have optimized radiation delivery, leading to shorter treatment durations and improved patient outcomes. Personalized treatment approaches, guided by genomic and molecular profiling, allow for customized dosimeter, maximizing therapeutic effectiveness while minimizing toxicity. Additionally, combining brachytherapy with other treatment modalities such as surgery, external beam radiation therapy (EBRT), and chemotherapy has demonstrated synergistic benefits, improving local control and reducing recurrence rates. Despite its advantages, brachytherapy faces challenges, including the invasive nature of the procedure, the need for specialized equipment and training, and limitations related to tumor size. Future directions in the field include advancements in imaging and dosimeter, the development of robotic-assisted brachytherapy, and more personalized treatment plans. These innovations promise to refine brachytherapy further and expand its applicability. This review highlights the transformative potential of recent advances in brachytherapy, emphasizing its evolving role in the localized treatment of oral cancers.
辐射进步:口腔肿瘤近距离放射治疗的未来
近距离放射治疗已成为口腔癌治疗不可或缺的一部分,其优势在于可直接向肿瘤提供高剂量辐射,同时最大限度地减少对周围健康组织的照射。本综述探讨了近来大大提高近距离放射治疗精确度和有效性的最新进展。核磁共振成像(MRI)和 CT 扫描等高分辨率成像技术的整合加强了肿瘤的划分,使放射源的放置更加精确。放射源的创新,尤其是高剂量率(HDR)近距离放射治疗,优化了放射线的输送,从而缩短了治疗时间,改善了患者的治疗效果。以基因组和分子图谱为指导的个性化治疗方法允许定制剂量计,在最大限度地提高治疗效果的同时最大限度地降低毒性。此外,近距离放射治疗与手术、体外放射治疗(EBRT)和化疗等其他治疗方式的结合已显示出协同效应,可改善局部控制并降低复发率。尽管近距离放射治疗具有诸多优势,但它也面临着一些挑战,包括手术的侵入性、对专业设备和培训的需求以及与肿瘤大小相关的限制。该领域未来的发展方向包括成像和剂量计的进步、机器人辅助近距离放射治疗的开发以及更加个性化的治疗方案。这些创新有望进一步完善近距离放射治疗并扩大其应用范围。这篇综述突出了近距离放射治疗最新进展的变革潜力,强调了近距离放射治疗在口腔癌局部治疗中不断发展的作用。
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