Combined external radiotherapy and single-fraction palliative high-dose-rate interstitial brachytherapy for a patient with a base of tongue cancer who had a previous radiation history.
{"title":"Combined external radiotherapy and single-fraction palliative high-dose-rate interstitial brachytherapy for a patient with a base of tongue cancer who had a previous radiation history.","authors":"Ken Yoshida, Yutaka Tanaka, Satoaki Nakamura, Asami Yoshida, Midori Yui, Kazuki Hirota, Katsuya Maebou, Zeyun Wang, Hideki Takegawa, Yusuke Anetai, Yuhei Koike, Toshiko Shiga, Hironori Akiyama, Naoya Murakami, Airi Asako, Yuhei Ogino, Hitoshi Nishimoto, Takuo Fujisawa, Masao Yagi, Hiroshi Iwai, Noboru Tanigawa","doi":"10.1007/s11282-024-00779-x","DOIUrl":null,"url":null,"abstract":"<p><p>Only a few studies have explored whether high-dose-rate interstitial brachytherapy (HDR-ISBT) can be indicated as a palliative/symptomatic treatment. We present the good results of palliative treatment using HDR-ISBT combined with external beam radiotherapy (ERT) in a patient of base of tongue cancer (cT4aN1M0). The patient was an 81-year-old male who complained of local pain. He had a previous irradiation history for head and neck cancer receiving ERT with systemic chemotherapy and radical surgery 15 years ago. Since it might be difficult for him to receive radical radiation doses using ERT alone, palliative ERT of relatively lower doses of 37.5 Gy in 15 fractions was selected. One month after ERT, HDR-ISBT was implemented as a booster. Considering the burden on physical condition, single-fraction HDR-ISBT was selected. We employed a new technique in which we did not penetrate the ventral surface of the tongue to reduce the risk of infection and bleeding. The planning-aim dose was 9.5 Gy. The dose that covered 90% of the clinical target volume was 9.6 Gy. The treatment ended without any problems. Acute complications were not observed. The tumor size decreased, and local pain disappeared at post-treatment day 84. No late complications were observed. Two years and 8 months after the treatment, the patient is alive without any obvious recurrence. Additional single-fraction HDR-ISBT boost may be a useful modality as a palliative/symptomatic intent. The implantation technique and dose-fraction schedule may be important for the safe treatment of older patients or those with poor performance status.</p>","PeriodicalId":56103,"journal":{"name":"Oral Radiology","volume":null,"pages":null},"PeriodicalIF":1.6000,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oral Radiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11282-024-00779-x","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Only a few studies have explored whether high-dose-rate interstitial brachytherapy (HDR-ISBT) can be indicated as a palliative/symptomatic treatment. We present the good results of palliative treatment using HDR-ISBT combined with external beam radiotherapy (ERT) in a patient of base of tongue cancer (cT4aN1M0). The patient was an 81-year-old male who complained of local pain. He had a previous irradiation history for head and neck cancer receiving ERT with systemic chemotherapy and radical surgery 15 years ago. Since it might be difficult for him to receive radical radiation doses using ERT alone, palliative ERT of relatively lower doses of 37.5 Gy in 15 fractions was selected. One month after ERT, HDR-ISBT was implemented as a booster. Considering the burden on physical condition, single-fraction HDR-ISBT was selected. We employed a new technique in which we did not penetrate the ventral surface of the tongue to reduce the risk of infection and bleeding. The planning-aim dose was 9.5 Gy. The dose that covered 90% of the clinical target volume was 9.6 Gy. The treatment ended without any problems. Acute complications were not observed. The tumor size decreased, and local pain disappeared at post-treatment day 84. No late complications were observed. Two years and 8 months after the treatment, the patient is alive without any obvious recurrence. Additional single-fraction HDR-ISBT boost may be a useful modality as a palliative/symptomatic intent. The implantation technique and dose-fraction schedule may be important for the safe treatment of older patients or those with poor performance status.
期刊介绍:
As the official English-language journal of the Japanese Society for Oral and Maxillofacial Radiology and the Asian Academy of Oral and Maxillofacial Radiology, Oral Radiology is intended to be a forum for international collaboration in head and neck diagnostic imaging and all related fields. Oral Radiology features cutting-edge research papers, review articles, case reports, and technical notes from both the clinical and experimental fields. As membership in the Society is not a prerequisite, contributions are welcome from researchers and clinicians worldwide.