Brachytherapy — head and neck cancer
Interstitial implantation of radioactive sources, brachytherapy, is frequently used in the treatment of head and neck cancers. Implanting radioactive isotopes is a means of not only obtaining high localized radiation doses to the tumor bed, but also minimizing normal tissue injury, since the radiation is delivered only to the area of neoplastic involvement. Brachytherapy has been practiced for many years; 226-Radium needles or 222-Radon sources were used initially , but it was not until the last decade that interstitial implants have become more popular, due to several factors. The availability of new isotopes, such as 125-Iodine (125I) for permanent implantation and 192-Iridium (192Ir) for removable procedures, has allowed more complex interstitial procedures to be performed, while the latter isotope, by making afterloading possible, has minimized radiation doses to medical personnel [2–4]. Computerized dosimetry has enabled implants to be pre-planned, so that ideal symmetry and proper placement of sources may be determined prior to the procedure, while post-implantation dosimetry not only allows radiation dose rates to be calculated with removable implants, but also provides a method of correlating results and complications with radiation doses . New implant techniques, to be discussed, have also contributed to our ability to perform these procedures effectively and safely. In this chapter, the common radioactive isotopes in use today will be described, as will the techniques of implantation and the results of treatment of selected primary sites and cervical lymph nodes.
KeywordsBase Tongue Radical Neck Dissection Radiation Dose Rate Permanent Implantation Nylon Tube
Unable to display preview. Download preview PDF.
- 1.Martin, C.L., Martin, J.A. 1965. Treatment of epithelioma of the lateral oropharynx with low intensity radium needle implants. A.J.R. 93: 7–19.Google Scholar
- 2.Kim, H., Hilaris, B. 1975. Iodine-125 source in interstitial tumor therapy. A.J.R. 123: 162–169.Google Scholar
- 4.Goffinet, D.R., Martinez, A., Pooler, D. et al. 1981. Brachytherapy renaissance. Front. Radiat. Ther. Oncol. 15: 43–57.Google Scholar
- 5.Sandor, J., Palos, B., Goffinet, D.R. et al. 1979. Dose calculations for planar arrays of 192Ir and 125I seeds for brachytherapy. Appl. Radiol. 8: 41–44.Google Scholar
- 9.Goffinet, D.R., Martinez, A., Pooler, D. 1981. 125I seed implantations as a surgical adjuvant in head and neck cancers. In: Kominierte Chirurgtische und Radiologische Therapie Maligner Tumoren (M. Wannenmacher, ed.). Urban & Schwarzenberg, München, pp. 46–48.Google Scholar
- 12.Goffinet, D.R. 1985. Head and neck brachytherapy emphasizing afterloading removable oropharyngeal implants. In: Head and Neck Cancer 1, (P.B. Chreten, M.E. Johns, O.P. Sherd, E.W. Strong, P.W. Ward, B.C. Decker Inc., Philadelphia, pp. 359–364.Google Scholar
- 15.Syed, A.M.N., Puthawala, A., Fleming, P. et al. 1980. Afterloading interstitial implant in head and neck cancer. Arch. Otolarynogol. 106: 541–546.Google Scholar