Intra-operative interstitial brachytherapy in a novel infra-zygomatic approach for partially resectable head and neck cancers around the base of skull: A technical note.

IF 1.1 4区 医学 Q4 ONCOLOGY
Siddanna R Palled, Jaswanthi Akkpatti Ramachandra Reddy, Purushottam Chavan, K Siddappa, R A Sunil, Sanjeet Kumar Mondal, Bindu Krishnappa Venugopal, V Lokesh
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Abstract

Purpose: To report an intra-operative catheter insertion technique into the base of skull tumor bed following surgical resection for maxillary tumors.

Material and methods: A 42-year-old male patient diagnosed with carcinoma of the maxilla was treated with neoadjuvant chemotherapy followed by chemo-radiation using external beam technique combined with brachytherapy boost to post-operative bed. Brachytherapy was delivered via intra-operative catheter placement at the base of skull to residual disease, which was surgically unresectable. Initially, catheters were placed cranio-caudally. This was later changed into an infra-zygomatic approach to improve planning and dose coverage. High-risk clinical tumor volume (CTV) was generated with a 3 mm margin to residual gross tumor. Planning was done using Varian Eclipse brachytherapy planning system, and an optimal plan was generated.

Conclusions: An innovative, beneficial, and safe brachytherapy approach is necessary in a difficult and critical area, such as the base of skull. Our novel method of implant insertion through infra-zygomatic approach resulted in a safe and successful procedure.

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术中间质近距离放射治疗一种新的颧下入路治疗部分可切除的颅底周围头颈癌:技术说明。
目的:报道上颌肿瘤切除术后术中颅骨肿瘤床底置管技术。材料与方法:1例男性,42岁,确诊为上颌骨癌,行新辅助化疗+化疗放疗联合近距离放疗至术后床。术中在颅底放置导管,对手术无法切除的残留病变进行近距离放射治疗。最初,导管放置在颅尾侧。这后来被改为颧下入路,以改善计划和剂量覆盖。高危临床肿瘤体积(CTV)产生与残余大体肿瘤有3mm的间隙。使用Varian Eclipse近距离治疗计划系统进行计划,并生成最优计划。结论:一种创新、有益、安全的近距离治疗方法在颅底等困难和关键部位是必要的。我们的新方法是通过颧下入路置入假体,手术安全成功。
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来源期刊
Journal of Contemporary Brachytherapy
Journal of Contemporary Brachytherapy ONCOLOGY-RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
CiteScore
2.40
自引率
14.30%
发文量
54
审稿时长
16 weeks
期刊介绍: The “Journal of Contemporary Brachytherapy” is an international and multidisciplinary journal that will publish papers of original research as well as reviews of articles. Main subjects of the journal include: clinical brachytherapy, combined modality treatment, advances in radiobiology, hyperthermia and tumour biology, as well as physical aspects relevant to brachytherapy, particularly in the field of imaging, dosimetry and radiation therapy planning. Original contributions will include experimental studies of combined modality treatment, tumor sensitization and normal tissue protection, molecular radiation biology, and clinical investigations of cancer treatment in brachytherapy. Another field of interest will be the educational part of the journal.
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