Brachytherapy of stage II mobile tongue carcinoma. Prediction of local control and QOL

BACKGROUND: There is no consensus as to the prognostic model for brachytherapy of tongue carcinoma. This study was designed to evaluate the prognostic factors for local control based on a large population under a unified treatment policy. RESULTS: Between 1970 and 1998, 433 patients with stage II tongue squamous cell carcinoma were treated by low-dose-rate brachytherapy. This series included 277 patients treated with a linear source with a minimum follow-up of 3 years. A spacer was introduced in 1987. The primary local control rates were 85.6%. CONCLUSION: In the multivariate analysis, an invasive growth pattern was a significant factor for local recurrence. The disease-related survival was influenced by old age and an invasive growth pattern. A spacer lowered mandibular bone complications. The growth pattern was the most important factor for recurrence. Brachytherapy was associated with a high cure rate and the use of spacers brought about good quality of life (QOL)

CT-guided iodine-125 seed permanent implantation for recurrent head and neck cancers

<p>Abstract</p> <p>Background</p> <p>To investigate the feasibility, and safety of ¹²⁵I seed permanent implantation for recurrent head and neck carcinoma under CT-guidance.</p> <p>Results</p> <p>A retrospective study on 14 patients with recurrent head and neck cancers undergone ¹²⁵I seed implantation with different seed activities. The post-plan showed that the actuarial D90 of ¹²⁵I seeds ranged from 90 to 218 Gy (median, 157.5 Gy). The follow-up was 3 to 60 months (median, 13 months). The median local control was 18 months (95% CI, 6.1-29.9 months), and the 1-, 2-, 3-, and 5- year local controls were 52%, 39%, 39%, and 39%, respectively. The 1-, 2-, 3-, and 5- survival rates were 65%, 39%, 39% and 39%, respectively, with a median survival time of 20 months (95% CI, 8.7-31.3 months). Of all patients, 28.6% (4/14) died of local recurrence, 7.1% (1/14) died of metastases, one patient died of hepatocirrhosis, and 8 patients are still alive to the date of data analysis.</p> <p>Conclusion</p> <p>CT-guided ¹²⁵I seed implantation is feasible and safe as a salvage or palliative treatment for patients with recurrent head and neck cancers.</p

InViVo-Brachy: a navigation system for interstitial brachytherapy

HDR brachytherapy is a is a kind of radio therapy that amongst other methods can be performed with interstitial needles. An important working step in this treatment is the fast and accurate implantation of several metallic pipe needles inside a tumour. In the procedure currently used in clinical routine a needle is placed stepwise by controlling the needle position and direction with newly acquired CT scans after every further insertion. This procedure is time consuming (1-2h for ca. 10-15 needles), therefore painful for the patient and relative inaccurate. The estimation of the necessary corrections of the needle direction is complicated and highly depends on the experience of the physician. Additionally the CT device is not available for other applications during this time. This work presents an application where the placement of the interstitial needles can performed fast and accurate by an image guided interactive navigation in a 3D CT data set of the patient