4.2 Article

The combination of volumetric arc radiation therapy and boost high-dose rate interstitial brachytherapy for T3N2c tongue cancer: a technical report

Journal

JAPANESE JOURNAL OF CLINICAL ONCOLOGY
Volume 53, Issue 1, Pages 85-90

Publisher

OXFORD UNIV PRESS
DOI: 10.1093/jjco/hyac160

Keywords

head and neck cancer; T3 tongue cancer; interstitial brachytherapy; HDR-ISBT boost; VMAT; IMRT

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This report presents a case study of a patient with T3N2cM0 tongue cancer who was effectively treated using concurrent chemoradiotherapy and boost high-dose rate interstitial brachytherapy. The authors believe that by carefully planning the radiation therapy to minimize mandible dose and combining it with a mouthpiece to protect the mandible, T3N2 disease can be treated, offering a treatment option for patients who wish to preserve organ function.
Currently, tongue cancers are primarily managed by surgery, and interstitial brachytherapy is only recommended for a selected group of early state T1-2N0 patients who refuse surgery or are medically inoperable. In this report, a case with T3N2cM0 tongue cancer who has been effectively treated by the combination of concurrent chemoradiotherapy involving volumetric arc therapy and boost high-dose rate interstitial brachytherapy is presented. Of course, surgery remains the main treatment strategy for tongue cancer patients; however, the authors believe that if volumetric arc therapy is carefully planned to reduce the mandible dose as much as possible and high-dose rate interstitial brachytherapy with a mouthpiece that protects the mandible is combined, it is possible to treat T3N2 disease, and this can be considered for patients who want to preserve organ function. This technical report discusses the use of high-dose rate interstitial brachytherapy boost combined with modern intensity-modulated radiation therapy and a dental mouthpiece for a locally advanced tongue cancer patient.

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