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Case Reports
. 2020 Jun;12(3):273-278.
doi: 10.5114/jcb.2020.96870. Epub 2020 Jun 30.

Single-fraction image-guided high-dose-rate brachytherapy for head and neck cancer: three cases of palliative brachytherapy

Yoshiaki Ota  1 , Koji Masui  1 , Gen Suzuki  1 , Hideya Yamazaki  1 , Kei Yamada  1
Affiliations
Case Reports

Single-fraction image-guided high-dose-rate brachytherapy for head and neck cancer: three cases of palliative brachytherapy

Yoshiaki Ota et al. J Contemp Brachytherapy. 2020 Jun.

Abstract

Purpose: To present a small series of cases, in which single-fraction image-guided high-dose-rate (HDR) brachytherapy was provided as palliative treatment for inoperable head and neck cancer cases.

Material and methods: We used this technique to treat 3 patients with symptomatic head and neck cancer (tongue cancer, gingival metastasis of osteosarcoma, and external auditory canal cancer), who were not eligible for a definitive treatment. The purpose of palliative brachytherapy in all 3 patients was the relief of symptoms such as difficulty in eating, talking, and hearing. All patients were treated with computed tomography (CT) image-guided interstitial HDR brachytherapy under local anesthesia in an outpatient setting, with a single dose of 10 Gy.

Results: Satisfactory palliative effects were achieved in all cases without serious side effects. The palliative effects were sustained in 2 patients until death, and 1 patient lived for 39 weeks before a relapse.

Conclusions: Our palliative treatment technique appears to be safe, effective, and less invasive, and could be a treatment option for symptomatic patients with head and neck cancer.

Keywords: brachytherapy; head and neck neoplasms; image-guided brachytherapy; palliative care.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Fig. 1
Fig. 1
Patient 1. A) Tongue cancer on the middle of dorsum linguae; B) Eight applicators placed inside the tumor with at least 1.5 cm space between them; C) Yellow circle indicates the contour of CTV; D) Tumor at 11 weeks after the treatment
Fig. 2
Fig. 2
Patient 2. A) Tumor on the right gingiva; B) Four applicators placed; C) Yellow circle indicates the CTV; D) Tumor at 5 weeks after the treatment
Fig. 3
Fig. 3
Patient 3. A) Direct view of the tumor; B) Pretreatment CT image showing the tumor occupying the external auditory canal; C) Applicator in the right external auditory canal; D) Yellow circle indicates the CTV
Fig. 4
Fig. 4
Patient 3. A, B) CT images show shrinkage of the tumor and patency of the external auditory canal; C, D) Audiometry shows improved hearing at 8 weeks after the treatment
See this image and copyright information in PMC

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