The Analysis of the outcome with High Dose Rate (H.D.R) Brachytherapy in Oropharyngeal Cancers Either Alone or with External Beam Radiotherapy (EBRT)

Title: The Analysis of the outcome with High Dose Rate (H.D.R) Brachytherapy in Oropharyngeal Cancers Either Alone or with External Beam Radiotherapy (EBRT)

Authors: Dr C.S.K. Prakash, M.D (R.T), Dr Kamreddy Ashok Reddy, M.S (ENT),Dr Lakkaraju Ravindra Babu, B.D.S

DOI: https://dx.doi.org/10.18535/jmscr/v4i10.121

Abstract

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Abstract

Purpose: We analysed the results of 34 patients of oropharyngeal carcinomas treated with HDR brachytherapy alone or with EBRT Patients and Methods: The outcome of patients treated with oropharyngeal cancers treated with HDR interstitial or mould brachytherapy alone or with EBRT were analysed. The patients underwent treatment between 2004and 2009 at M.N.J. Institute of Oncology and Regional Cancer Centre, Hyderabad. The minimum follow up period was 24 months.

Patients with T1, T2 lesions received EBRT 50Gy. T3 lesions had 56Gy and T4 lesions had 60 Gy. Patients with residual neck nodes had 10Gy of additional electron boost. Patients having no palpable neck nodes had interstitial brachytherapy. For all patients 3 Gy per fraction, for 5-6 fractions, with 2 fractions per day with minimum interval between two fractions was 6 hours. The first and the last fraction the dose of 4Gy was administered instead of 3Gy. Six patients with carcinoma hard palate were treated with HDR mould brachytherapy with 42-45Gy/14-15Fractions. The outcome was analysed.

Results: Patients with T1 and T2 lesions 90%patients ,while 78.57%) T3, T4 lesions had no evidence of recurrence and none of the patients with T1, T2 developed complications and 7.14% of T3, T4 patients had complications like necrosis or necrosis and fistulae. Patients with T1N0M0 hard palate carcinomas, treated by mould brachytherapy had 100% local control rates and 0% long term complications of radiotherapy.

Conclusion: Oropharyngeal carcinomas can be best treated with combination of EBRT and HDR brachytherapy. Hard palate T1N0M0 lesions can be best treated by HDR mould brachytherapy, thereby reducing overall treatment time and complications.

Keywords: Oropharyngeal carcinomas and High Dose Rate (HDR) brachytherapy.

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