Open AccessImage-guided interstitial brachytherapy boost for keratinizing squamous cell carcinoma of inferior wall of the nasopharynx
Author(s) -
Naoya Murakami,
Seiichi Yoshimoto,
Masakazu Uematsu,
Tairo Kashihara,
Kana Takahashi,
Koji Inaba,
Kae Okuma,
Hiroshi Igaki,
Yuko Nakayama,
Koji Masui,
Ken Yoshida,
Jun Itami
Publication year - 2020
Publication title -
bjr case reports
Language(s) - English
Resource type - Journals
ISSN - 2055-7159
DOI - 10.1259/bjrcr.20200005
Subject(s) - medicine , brachytherapy , basal cell , radiology , nuclear medicine , radiation therapy , pathology
High-dose-rate interstitial brachytherapy (HDR-ISBT) is relatively rarely applied for the head and neck cancer because of its anatomical complexity and difficulty of applicator placement. However, its dose distribution is more confined even better than intensity-modulated radiation therapy (IMRT) and can deliver a higher dose while sparing surrounding normal tissues. In this case report, the effectiveness of HDR-ISBT as a boost following IMRT for keratinizing squamous cell carcinoma of nasopharynx was presented. A 76-year-old female who suffered from cT3N0M0 keratinizing squamous cell carcinoma of the nasopharynx was treated with definitive concurrent chemoradiation therapy involving IMRT. However, physical examination and laryngoscope fibre finding showed evident residual tumour at 60 Gy of IMRT, then, boost HDR-ISBT was proposed. After delivering 66 Gy of IMRT, CT image-guided HDR-ISBT 4 Gy in a single fraction was performed under local anaesthesia and sedation. MRI taken 5 months after HDR-ISBT showed remarkable shrinkage of the primary tumour. After HDR-ISBT, the remaining session of IMRT was delivered from the next day until 70 Gy in 35 fractions. It was demonstrated that boost HDR-ISBT combined with IMRT for keratinizing squamous cell carcinoma of the nasopharynx was performed safely and showed favourable efficacy.