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Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa.

Vedasoundaram P, Prasanna AK, Ks R, Selvarajan G, Sinnatamby M, Ramapandian S, Kandasamy S - Springerplus (2014)

Bottom Line: Five patients had residual disease and were referred for surgical salvage.One patient died of disease progression.Stage I patients had 100% local control, whereas Stage II and Stage III patients had 84.6% and 80% local control respectively.

View Article: PubMed Central - PubMed

Affiliation: Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India.

ABSTRACT

Background: The study aimed to assess the effect of High Dose Rate (HDR) Interstitial Brachytherapy when used alone or in combination with External Beam Radiotherapy (EBRT), in early and locally advanced squamous cell carcinoma of buccal mucosa.

Materials and methods: Thirty three patients with histologically proven squamous cell carcinoma of the buccal mucosa received high dose rate interstitial brachytherapy either as primary treatment or as a boost from November 2008 to April 2013. Stage I patients received interstitial brachytherapy alone to a dose of 38.50 Gy, 3.5 Gy per fraction, twice daily at six hours apart for 11 fractions. Stage II patients received EBRT to a dose of 50 Gy in 25 fractions of two Gy each followed by brachytherapy boost to 21 Gy, 3.5 Gy per fraction, twice daily at six hours apart for six fractions. Stage III patients received the same radiotherapy schedule (i.e., same EBRT & Brachytherapy schedule) and with addition of Injection Cisplatin 70 mg/m(2) in three divided doses every three weeks along with EBRT.

Results: Follow up ranged from 12 to 60 months, median follow up was 26 months. Complete response was observed in 28 patients. Five patients had residual disease and were referred for surgical salvage. One patient died of disease progression. Stage I patients had 100% local control, whereas Stage II and Stage III patients had 84.6% and 80% local control respectively.

Conclusion: HDR Interstitial Brachytherapy used either as a primary treatment modality or as a boost in buccal mucosal cancers provides results comparable to that of surgery, with the advantages of organ preservation, better cosmetic and functional outcomes.

No MeSH data available.


Related in: MedlinePlus

Interstitial implants connected to HDR after loading catheters.
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Fig3: Interstitial implants connected to HDR after loading catheters.

Mentions: Table 2 shows the overall outcome of the treatment. 28 patients (84.84%) had complete response. Figures 1,2,3,4 and5 shows the pretreatment evaluation, treatment and post treatment follow-up of one patient; who is disease free till date. Five patients (15.15%) had residual disease. All patients with residual disease were referred to surgical oncology department for salvage surgery. Four patients had good salvage surgery and had no further events during the follow-up period. One patient progressed after surgery and was given palliative chemotherapy with Injection Cisplatin and Paclitaxel. But the disease progressed and ultimately the patient succumbed to the disease.Table 2


Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa.

Vedasoundaram P, Prasanna AK, Ks R, Selvarajan G, Sinnatamby M, Ramapandian S, Kandasamy S - Springerplus (2014)

Interstitial implants connected to HDR after loading catheters.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4197196&req=5

Fig3: Interstitial implants connected to HDR after loading catheters.
Mentions: Table 2 shows the overall outcome of the treatment. 28 patients (84.84%) had complete response. Figures 1,2,3,4 and5 shows the pretreatment evaluation, treatment and post treatment follow-up of one patient; who is disease free till date. Five patients (15.15%) had residual disease. All patients with residual disease were referred to surgical oncology department for salvage surgery. Four patients had good salvage surgery and had no further events during the follow-up period. One patient progressed after surgery and was given palliative chemotherapy with Injection Cisplatin and Paclitaxel. But the disease progressed and ultimately the patient succumbed to the disease.Table 2

Bottom Line: Five patients had residual disease and were referred for surgical salvage.One patient died of disease progression.Stage I patients had 100% local control, whereas Stage II and Stage III patients had 84.6% and 80% local control respectively.

View Article: PubMed Central - PubMed

Affiliation: Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India.

ABSTRACT

Background: The study aimed to assess the effect of High Dose Rate (HDR) Interstitial Brachytherapy when used alone or in combination with External Beam Radiotherapy (EBRT), in early and locally advanced squamous cell carcinoma of buccal mucosa.

Materials and methods: Thirty three patients with histologically proven squamous cell carcinoma of the buccal mucosa received high dose rate interstitial brachytherapy either as primary treatment or as a boost from November 2008 to April 2013. Stage I patients received interstitial brachytherapy alone to a dose of 38.50 Gy, 3.5 Gy per fraction, twice daily at six hours apart for 11 fractions. Stage II patients received EBRT to a dose of 50 Gy in 25 fractions of two Gy each followed by brachytherapy boost to 21 Gy, 3.5 Gy per fraction, twice daily at six hours apart for six fractions. Stage III patients received the same radiotherapy schedule (i.e., same EBRT & Brachytherapy schedule) and with addition of Injection Cisplatin 70 mg/m(2) in three divided doses every three weeks along with EBRT.

Results: Follow up ranged from 12 to 60 months, median follow up was 26 months. Complete response was observed in 28 patients. Five patients had residual disease and were referred for surgical salvage. One patient died of disease progression. Stage I patients had 100% local control, whereas Stage II and Stage III patients had 84.6% and 80% local control respectively.

Conclusion: HDR Interstitial Brachytherapy used either as a primary treatment modality or as a boost in buccal mucosal cancers provides results comparable to that of surgery, with the advantages of organ preservation, better cosmetic and functional outcomes.

No MeSH data available.


Related in: MedlinePlus