Journal article
Simulation study of high-dose-rate brachytherapy for early glottic cancer
Brachytherapy, Vol.15(1), pp.94-101
01/2016
DOI: 10.1016/j.brachy.2015.10.007
PMID: 26614234
Abstract
External beam radiation therapy (EBRT) is effective for early glottic cancers, with cure rates of ∼90% for T1 tumors. EBRT has strengths but also disadvantages including radiation to healthy tissues and duration of 5–7 weeks. With advances in laryngeal framework surgery, new devices can provide reliable, minimally invasive access to the larynx. Such devices could be modified to insert brachytherapy catheters. Brachytherapy could provide focused radiation while limiting dose to normal structures in the larynx and neck. As a preliminary step, we performed simulations comparing EBRT to high-dose-rate brachytherapy to assess if this approach could provide dosimetric advantage.
One- and 2-catheter brachytherapy simulations were performed for 3 patients with T1 glottic carcinoma. Percentage of dose delivered to the target and adjacent structures was compared with conventional EBRT using 3D and intensity-modulated radiation therapy approaches.
Percentage of structures exposed to 50% of the dose was lower for brachytherapy compared with 3D EBRT and intensity-modulated radiation therapy, particularly for the cricoid and contralateral arytenoid. Dose was also lower for the carotid-internal jugular vein complexes compared with 3D EBRT. Dose profiles did not differ significantly between 1- and 2-catheter simulations.
Brachytherapy can decrease radiation to normal tissues including laryngeal cartilages and carotid-internal jugular vein complexes. Recent advancements allowing catheter placement may afford the potential to decrease radiation to healthy tissues with decreased treatment time. However, careful, stepwise evaluation of feasibility and outcomes in model systems is required before recommending this approach for such high cure rate cancers in humans.
Details
- Title: Subtitle
- Simulation study of high-dose-rate brachytherapy for early glottic cancer
- Creators
- Matthew R. Hoffman - University of Wisconsin–MadisonTimothy M. McCulloch - University of Wisconsin–MadisonPranshu Mohindra - University of Wisconsin–MadisonRupak Das - University of Wisconsin–MadisonMark Geurts - University of Wisconsin–MadisonPaul M. Harari - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- Brachytherapy, Vol.15(1), pp.94-101
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.brachy.2015.10.007
- PMID
- 26614234
- ISSN
- 1538-4721
- eISSN
- 1873-1449
- Language
- English
- Date published
- 01/2016
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984366374502771
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