Get started
Work

Image-guided high-dose-rate interstitial brachytherapy with custom-made surface applicators for lower lip cancer as monotherapy. Technique, long-term clinical results, and quantitative dose-volume evaluation: A case series

Year: 2025
Type: article
Abstract: Purpose: This study showed long-term clinical results and quantitative dose-volume evaluation of image-guided high-dose-rate interstitial brachytherapy (IG HDR-BT) with custom-made surface applicators for lower lip cancer as monotherapy.Material and methods: Patients with localized lower lip cancer, who received IG HDR-BT with custom-made surface applicators as monotherapy at the NHO Osaka National Hospital between February 2012 and January 2015 were enrolled in this study.One to three applicators were implanted interstitially, and two to six were placed on tumor surface.Planning-aimed dose (PAD) was 54 Gy, 48 Gy for a recurrent case, and irradiation was delivered at 6 Gy/fraction, twice a day.Dosimetric goal was to achieve D 90 : clinical target volume (CTV) > PAD without excessive dose to the mandible.A lead shield was placed between the gingiva and lower lip during irradiation to reduce the dose to the mandible in all but one edentulous patient.A gauze with 2% lidocaine was inserted intra-orally to reduce the dose to the upper lip and maxilla.Results: Six patients (T1 : T2 : T3 = 3 : 2 : 1), including one recurrent case, were enrolled in this study.The CTV was contoured on computed tomography and in two cases, magnetic resonance imaging was used as a reference for contouring.The median follow-up was 69.5 months.The primary tumor was controlled in all cases.No serious late adverse reactions were observed.The median D 90 (CTV) and V 100 (PAD) were 108.9%PAD and 99.3% CTV, respectively.The median D 0.1cm3 (mandible) was 3.2 Gy per fraction.Conclusions: IG HDR-BT with custom-made surface applicators for lower lip cancer as monotherapy showed an excellent CTV dose and acceptable doses to the mandible, with good long-term clinical results.
DOI: 10.5114/jcb.2025.147943
Authors: Hironori Akiyama, Ken Yoshida, Tadayuki Kotsuma, Tadashi Takenaka, Yuji Takaoka, Masataka Nakai, Manabu Kano, Hitoshi Yoshimoto, Kentaro Ozawa, Zoltán Takácsi-Nagy, Koji Masui, Hideya Yamazaki, Yoshiko Ariji, Eiichi Tanaka
Institutions: Osaka National Hospital, Osaka Dental University, Kansai Medical University, Kansai Medical University Medical Center, Osaka Rosai Hospital, Kyoto Prefectural University of Medicine, Semmelweis University, National Institute of Oncology
Language: English
Subfield: Radiation
Open Access status: gold
Estimated APC paid: $269
OpenAlex ID: W4407925005
FWCI: 0.509
Cites: 23
Cited by: 1
Related to: 10