title: Brachytherapy for primary and recurrent nasopharyngeal carcinoma: treatment techniques and results.
abstract: OBJECTIVE
  Nasopharyngeal cancer is the commonest head and neck cancer in Tunisia treated with radiotherapy. A dose effect relationship is established in this tumor. The aim of this study is to describe our Low-dose-rate endocavitary brachytherapy using a personalized mold called Tunis applicator.
  
  
  METHODS
  Seven patients (4 males and 3 females) with histologically confirmed undifferentiated nasopharyngeal carcinoma (UCNT) were treated between 2002 and 2005. Five patients with primary cancer and 2 with recurrent disease received external beam radiation followed by endocavitary brachytherapy. The mean applied dose of endocavitary brachytherapy was 5.5 Gy for primary site after external beam radiation (70-74 Gy) and 30 Gy for recurrent disease after external beam radiation (38 Gy). We have developed a personalized applicator with a balloon to optimize the placement of sources and a better conformity using the computer tomography scanning. Critical normal structures were identified on orthogonal radiographs and the dose was optimized to avoid excessive doses to these structures.
  
  
  RESULTS
  With a follow up of 18 months (8-41), only one local failure was observed, 3 years after external beam radiation therapy for a recurrent disease. Moderate grade mucositis was seen in most patients. One patient was diagnosed with bulb necrosis.
  
  
  CONCLUSIONS
  Endobrachytherapy can provide effective treatment for nasopharyngeal carcinoma with an easy application of the brachytherapy procedure.
authors.affiliation: Radio-Oncology Department Salah Azaiz Cancer Institute, boulevard du 9-Avril, 1006 Tunis, Tunisia.
authors.forename: M
authors.initials: M
authors.lastname: Maalej
authors.forename: C N
authors.initials: CN
authors.lastname: Ben Ammar
authors.forename: L
authors.initials: L
authors.lastname: Kochbati
authors.forename: H
authors.initials: H
authors.lastname: Frikha
authors.forename: D
authors.initials: D
authors.lastname: Hentati
authors.forename: W
authors.initials: W
authors.lastname: Gargouri
authors.forename: M
authors.initials: M
authors.lastname: Besbes
mesh_terms: D000328:Adult; D001918:Brachytherapy / Q000295:instrumentation / Q000379:methods*; D002277:Carcinoma / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D052016:Mucositis / Q000209:etiology; D009302:Nasopharyngeal Diseases / Q000532:radiotherapy*; D009364:Neoplasm Recurrence, Local / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D016896:Treatment Outcome