Interstitial Brachytherapy in Head and Neck Tumors

  • Basil S. Hilaris
  • Anca E. Tchelebi
  • Chitti R. Moorthy
Part of the Medical Radiology book series (MEDRAD)

Abstract

Brachytherapy presently, in spite of the extensive utilization of external megavoltage radiation, plays a significant role in the management of head and neck cancer. The early techniques of interstitial brachytherapy using radium needles were developed in the early 1920s in Paris by Regaud, Lacassagne, and Coutard (see del Regato 1986, 1987). Paterson and parker in 1934 developed the dosage system known as the Manchester, which placed interstitial brachytherapy on a more rational basis. Paterson recognized very early on that the dose that can be safely delivered by brachytherapy varied with the volume implanted and that the smaller the volume, the greater the tolerance. This marked dependency of the tissue tolerance dose on the size of the irradiated volume is the key to understanding the value of interstitial brachytherapy in head and neck cancer. The other advantage of brachytherapy, and we refer to the precise localization of the radiation effect, is more evident in the head and neck because of easy tumor accessibility and visibility. The role of brachytherapy was strengthened by the introduction of afterloading techniques and artificial radionuclides, especially iridium 192, in the mid 1950s by Henschke et al. (1963) in New York. Recent developments in computer technology and the imaging revolution have created the tools to describe the patient’s anatomy and to calculate and display dose distributions (Hilaris et al. 1987a). Thus, interstitial brachytherapy continues to be an indispensable adjunct to the management of many head and neck cancers.

Keywords

Zinc Peroxide Carbohydrate Fluoride Radium 

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References

  1. Anderson LL (1986) A “natural volume-dose histogram for brachytherapy. Med Phys 13: 898–903PubMedCrossRefGoogle Scholar
  2. Baillet F (1980) Tumeurs de la base de langue. C R Soc Fr Radiol 1: 140–141Google Scholar
  3. Baillet P, et al. (1982) Résultats d’une étude multicentre concernant 966 épitheliomas due plancer de la bouche. J Eur Radiother 3: 147–152Google Scholar
  4. Chung CK, et al (1979) Squamous cell carcinoma of the soft palate and uvula. Int J Radiai Oncol Biol Phys 5: 845–850Google Scholar
  5. Del Regato JA (1986) History and heritage; Antoine Lacassagne. Int J Radiat Oncol Biol Phys 12: 2165–2173PubMedCrossRefGoogle Scholar
  6. Del Regato JA (1987) History and heritage; Henri Coutard. Int J Radiai Oncol Biol Phys 13: 433–443CrossRefGoogle Scholar
  7. Dutreix A, et al. (1982) Dosimétrie en curiethérapie. Masson, Paris, pp 109–138Google Scholar
  8. Gardner KE, et al. (1987) Time-dose relationships for local tumor control and complications following irradiation of squamous cell carcinoma of the base of tongue. Int J Radiat Oncol Biol Phys 13: 507–510PubMedCrossRefGoogle Scholar
  9. Glasser O, et al. (1961) Physical foundations of radiology, 3rd edn. Harper and Row, New YorkGoogle Scholar
  10. Goffinet DR (1984) Iridium 192 removable oropharyngeal interstitial implants of the tonsillo-palatine and base tongue regions. In: Hilaris BS, et al. (eds) Brachytherapy oncology update. Memorial Sloan-Kettering Cancer Center, New York, pp 69–80Google Scholar
  11. Goffinet DR, et al. (1985) 125 I vicryl suture implants as a surgical adjuvant in cancer of the head and neck. Int J Radiat Oncol Biol Phys 11: 399–402PubMedCrossRefGoogle Scholar
  12. Haie C, et al. (1986) Results of brachytherapy in the management of oral cavity cancer (Abstr). Endocuriether Hypertehermia Oncol 2: 60Google Scholar
  13. Henschke UK, et al. (1963) After-loading in interstitial and intracavitary radiation therapy. AJR 90: 386–395Google Scholar
  14. Hilaris BS, et al. (1987a) New approaches to brachytherapy. In: DeVita VA, et al. (eds) Important advances in oncology 1987, vol 12/2. Lippincott, Philadelphia, pp 237–261Google Scholar
  15. Hilaris BS, et al. (1987b) Brachytherapy treatment planning. Front Radias Ther Oncol 21: 94–106Google Scholar
  16. Hilaris BS, et al. (1988a) Interstitial Brachytherapy Planning and Evaluation In: Hilaris BS, et al. (eds) An atlas of brachytherapy. Macmillan, New York, pp 70–95Google Scholar
  17. Hilaris BS, et al. (1988b) Brachytherapy Techniques In: Hilaris BS, et al. (eds) An atlas of brachytherapy. Macmillan, New York, pp 46–69Google Scholar
  18. Housset M, et al. (1986) A retrospective study of three treatment techniques for T1–T2 base of tongue lesions: surgery plus postoperative radiation, external radiation plus interstitial implantation and external radiation alone. Int J Radiat Oncol Biol Phys 13: 511–516Google Scholar
  19. Larson DL (1983) Major complications of radiotherapy in cancer of the oral cavity and oropharynx. A 10 year retrospective study. Am J Surg Oncol 146: 531–536Google Scholar
  20. Leborgne JH, et al. (1986) The place of brachytherapy in the treatment of carcinoma of the tonsil with lingual extension. Int J Radiat Oncol Biol Phys 12: 1787–1792PubMedCrossRefGoogle Scholar
  21. Lo K, et al. (1987) Results of irradiation in the squamous cell carcinomas of the anterior faucial pillar retromolar trigone. Int J Radiat Oncol Biol Phys 13: 969–974PubMedCrossRefGoogle Scholar
  22. Marcial VA, et al. (1987) Hyperfractioned photon radiation therapy in the treatment of advanced squamous cell carcinoma of the oral cavity, pharynx, larynx, and sinuses, using radiation therapy as the only planned modality (preliminary report by the Radiation Therapy Oncology Group RTOG). Int J Radiat Oncol Biol Phys 13: 41–47PubMedCrossRefGoogle Scholar
  23. Mazeron JJ, Richaud P (1984) Compte rendu de la XVIII réunion du Groupe European de Curiethérapie. Session consacrée aux cancers de la lévère. J Eur Radiother 5: 50–56Google Scholar
  24. Mazeron JJ, et al. (1982) Analysis of local failures after treatment with curietherapy using iridium 192 for squamous cell carcinoma of the mobile tongue. J Eur Radiother 3: 131–138Google Scholar
  25. Mazeron JJ, et al. (1986) Interstitial radiation therapy for squamous cell carcinoma of the tonsillar region. The Creteil experience (1971–1981). Int J Radiat Oncol Biol Phys 12: 895–900PubMedCrossRefGoogle Scholar
  26. Mazeron JJ, et al. (1987a) Definitive radiation treatment for early stage carcinoma of the soft palate and uvula: the indications for iridium 192 implantation. Int J Radiat Oncol Biol Phys 13: 1829–1837PubMedCrossRefGoogle Scholar
  27. Mazeron JJ, et al. (1987b) Salvage irradiation of oropharyngeal cancers using iridium 192 wire implants: 5-year results of 70 cases. Int J Radiat Oncol Biol Phys 13: 957–962PubMedCrossRefGoogle Scholar
  28. Mazeron JJM, et al. (1988) Limited external irradiation and iridium-192 implantation in the treatment of squamous cell carcinoma of the oropharynx (Abstr). Hospital Henri Mondor, Creteil, France. 2nd International Conference on Head and Neck Cancer, July 31-Aug 5, BostonGoogle Scholar
  29. Meredith WJ (ed) 1967 Radiation dosage, the Manchester system, 2nd ed. Livingstone, EdinburghGoogle Scholar
  30. Parsons JT, et al. (1988) Hyperfractionation for head and neck cancer. Int J Radiat Oncol Biol Phys 14: 649–658PubMedCrossRefGoogle Scholar
  31. Paryani SB, et al. (1985) Suture implants in the management of advanced tumors in the neck attached to the carotid artery. J Clin Oncol 3: 809–812PubMedGoogle Scholar
  32. Paterson R, Parker HM (1934) A dosage system for gamma ray therapy. Br J Radiol 7: 592–612CrossRefGoogle Scholar
  33. Pernot M, Baillet F (1987) Hard and Soft Palate In: Pierquin B, et al. (eds) Modern brachytherapy. Masson, Paris, 137Google Scholar
  34. Pernot M, Gerbaulet A (1987) Buccal mucosa: In: Pierquin B, et al. (eds) Modern brachytherapy. Masson, Paris, pp 101–106Google Scholar
  35. Pigneux J, et al. (1979) The place of interstitial therapy using iridium-192 in the management of carcinoma of the lip. Cancer 43: 1073–1077PubMedCrossRefGoogle Scholar
  36. Puthawala AA, et al. (1985) Limited external irradiation and interstitial iridium-192 implant in the treatment of squamous cell carcinoma of the tonsillar region. Int J Radiat Oncol Biol Phys 11: 1595–1602PubMedCrossRefGoogle Scholar
  37. Puthawala AA, et al. (1988) Limited external beam and interstitial iridium 192 irradiation in the treatment of carcinoma of the base of the tongue: a ten year experience. Int J Radiat Oncol Biol Phys 14: 839–848PubMedCrossRefGoogle Scholar
  38. Sealy R, et al. (1984) The treatment of cancer of the uvula and soft palate with interstitial radioactive wire implants. Int J Radiat Oncol Biol Phys 10: 1951–1955PubMedCrossRefGoogle Scholar
  39. Son YH, Kacinski BM (1987) Therapeutic concepts of brachytherapy/megavoltage in sequence for pharyngeal wall cancers. Cancer 59: 1268–1273PubMedCrossRefGoogle Scholar
  40. Vikram B, et al. (1983) Permanent iodine-125 implants in head and neck cancer. Cancer 51: 1310–1314PubMedCrossRefGoogle Scholar
  41. Vikram, B, et al. (1985) A non-looping afterloading technique for base of tongue implants: results in the first 20 patients. Int J Radiat Oncol Biol Phys 11: 1853–1855PubMedCrossRefGoogle Scholar
  42. Wang CC (1988) Local control of oropharyngeal carcinoma after two accelerated hyperfractionation radiation therapy schemes. Int J Radiat Oncol Biol Phys 14: 1143–1146PubMedCrossRefGoogle Scholar
  43. Wang CC, et al. (1985) Twice-a-day radiation therapy for cancer of the head and neck. Cancer 55: 2100–2104PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1991

Authors and Affiliations

  • Basil S. Hilaris
  • Anca E. Tchelebi
    • 1
  • Chitti R. Moorthy
    • 1
  1. 1.Department of Radiation MedicineNew York Medical CollegeValhallaUSA

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