UNUSUAL SITES OF BRACHYTHERAPY IN HEAD AND NECK CANCER
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This document discusses the use of brachytherapy in treating head and neck cancers. It aims to deliver high doses of radiation directly to tumors while sparing surrounding normal tissues and minimizing side effects. Various unusual sites for brachytherapy are described, including the maxillary sinus, nasal vestibule, skin, ear canal, orbit, and parotid gland. Case studies demonstrate brachytherapy techniques like mould, interstitial, and sandwich applications. Doses, fractions, and treatment planning are also discussed.
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UNUSUAL SITES OF BRACHYTHERAPY IN HEAD AND NECK CANCER
- 1. UNUSUAL SITES OF BRACHYTHERAPY IN HEAD AND NECK CANCER DR KANHU CHARAN PATRO MD,DNB(RADIATION ONCOLOGY),MBA,FICRO,FAROI(USA),PDCR,CEPC HOD,RADIATION ONCOLOGY Mahatma Gandhi Cancer Hospital And Research Institute, Visakhapatnam drkcpatro@gmail.com /M- +91-9160470564
- 2. GOALS High dose to tumor tissue-Tumor control Normal tissue sparing Minimize long and short-term toxicities Better Quality of life 8/4/2023 1:40:23 AM 2
- 3. SBRT STEREOTACTIC BODY RADIOTHERAPY 1. HIGH DOSE 2. STRICT IMMOBILIZATION 3. MOTION MANAGEMENT 4. TARGET • GTV • +CTV • PTV SABT STEREOTACTIC ABLATIVE BRACHYTHERAPY
- 6. Brachytherapy 8/4/2023 1:40:23 AM 6 SHORT DISTANCE /CONTACT WITH TUMOR EXPERTISE NEEDED INVASIVE PROCEDURE ADEQUETLY SPARING NORMAL STRUCTURE WELL ESTABLISHED
- 7. 1. TRISMUS 2. DYSGUESIA 3. XEROSTOMIA 4. DYSPHAGIA 8/4/2023 7
- 9. DOCTOR : WHAT TRETMENT YOU HAVE GIVEN , I AM NOT ABLE TO EAT PANIPURI. THAT PANIPURI MOMENT 8/4/2023 9
- 11. • Lip • Buccal mucosa • Gingiva • Mandible • Orla tongue • Hard palate • Floor of mouth • RMT
- 12. Brachytherapy in oral cavity cancers 8/4/2023 1:40:23 AM 12
- 14. • Clinical examination • Upper GI Endoscopy • MRI/CT • BIOPSY • IHC
- 15. 8/4/2023 1:40:23 AM 15
- 16. EBRT Bird’s eye view BRACHY Eagle’s eye view 8/4/2023 Mahatma Gandhi Cancer Hospital & Research 16
- 19. Case details 1. A 61-year-old male was previously admitted to another hospital and received surgery because of left maxillary sinus squamous cell carcinoma (SCC) 6 years ago. 2. Tumor regrowth was noted 2 years after the initial radical surgery. The patient accepted local excision again for the recurrence, followed by external beam radiotherapy. 3. Despite salvage treatment with surgery and external irradiation, the lesion expanded as 4.8 × 4.4 × 4.0 cm3. Because the patient refused palliative resection, we recommended technique of image-guided HDR interstitial brachytherapy. 4. The total doses of 42 Gy in 12 fractions were delivered to the whole recurrent tumor
- 20. Imaging
- 21. Procedure
- 22. Isodose
- 26. The tumor is irradiated by a standardized fractionation: 44 Gy total dose, 3 Gy per fraction, except first and last fraction 4 Gy, two fractions per day (b.i.d.), 6 hr interval between the fractions, maximum overall treatment time 10 days NASAL VESTIBULAR INTERSTITAL BRACHY
- 27. NASAL VESTIBULAR MOULD BRACHY
- 28. CASE-3 SKIN RECURRENCE BRACHYTHERAPY BY DR. KANHU
- 30. INTRA-OP
- 31. INTRA-OP
- 33. POST TREATMENT
- 34. CASE- 4 EAR CANAL BRACHY BY DR. KANHU
- 44. WHO PRESERVES HE DESERVES
- 54. CASE- 7 BULKY SEBAEOUS GLAND OF EYE LID
- 57. The radiation dose was 54 Gy in 9 fractions.
- 59. CASE- 8 PAROTID GLAND BRACHYTHERAPY
- 61. Case details • Thirteen patients with advanced carcinomas of the parotid gland were included and treated with 125I interstitial brachytherapy in Peking University School and Hospital of Stomatology from January 2003 to December 2015. • All patients were treated with 125I interstitial brachytherapy as a sole modality for the primary tumor. • Furthermore, all of them were treated with neck dissection with/without adjunctive external beam radiotherapy for the neck, simultaneously. • The prescription dose of interstitial brachytherapy was 140 to160 Gy
- 65. CASE- 9 Recurrent alveolar carcinoma
- 71. CASE- 10 CARCINOMA NASAL CAVITY
- 72. • An 87-year-old man presented with epistaxis. A biopsy of a 1- cm lesion at the anterior left nasal septum was positive for well- differentiated squamous cell carcinoma. • CT of the head and neck reveals the lesion (a). He was treated with brachytherapy. T • Ten stainless-steel needles were placed in the left nasal ala, nasal tip, and left nasal septum and were afterloaded with 192Ir wires. • A total dose of 60 Gy was delivered over 3.5 days. CT dosimetry was obtained and isodose distributions are shown on an axial plane through the tumor • The patient had no evidence of disease and no symptoms 3 years after treatment.
- 77. CASE- 11 EYE LID BRACHYTHERAPY
- 84. CASE- 12 LIP BRACHYTHERAPY BY MOULD
- 85. 8/4/2023 1:40:23 AM 85
- 86. 8/4/2023 1:40:23 AM 86
- 87. Applicator in situ with IOP
- 88. Complete response –towards healing hypo-pigmentation
- 89. Recent
- 90. CASE- 13 SANDWICH MOULD AND INTERSTITIAL DR P S BHATTACHRYYA
- 91. Case details • 80year • Squamous sell carcinoma • Upper eyebrow area
- 101. CASE- 15 OTHERS
- 112. 8/4/2023 Mahatma Gandhi Cancer Hospital & Research Institute,Visakhapatnanm 112
- 115. ARTICLES TO FOLLOW
- 126. Radical
- 127. Boost
- 128. Boost
- 129. SMART THINKING 8/4/2023 1:40:23 AM 129
- 130. 8/4/2023 Mahatma Gandhi Cancer Hospital & Research Institute,Visakhapatnanm 130
- 131. 8/4/2023 1:40:23 AM 131
- 132. 8/4/2023 1:40:23 AM 132
- 133. 8/4/2023 1:40:23 AM 133
- 134. MY REGARDS
- 135. 8/4/2023 1:40:23 AM 135
- 136. NO AMPUTATION PLEASE 8/4/2023 1:40:23 AM 136
- 140. • Radiation oncologist We are the best plastic surgeons
- 141. 10/20/12 01:12 PM 141
- 142. 10/20/12 01:12 PM 142
- 143. 143 WE HAVE ONLY ONE EXCUSES SURGEONS DO NOT SEND THE CASES
- 144. DATING WITH SURGEON
- 145. READ MY BOOK
- 146. 10/20/12 01:12 PM 146 Whenever not possible, make friends
- 150. 150 ?