title: Cesium implant for tongue carcinoma with a thickness of 1.5 cm or more: cases successfully treated with a Modified Manchester System.
abstract: OBJECTIVE
  Deciding on treatment carcinoma of the tongue when the tumor has a thickness of 1.5 cm or more is difficult. Surgery often requires wide resection and re-construction, leading to considerable functional impairment. A cesium implant is an attractive option, but according to the Manchester System, a two plane implant is needed.
  
  
  METHODS
  According to the textbook, a tumor is sandwiched between the needles, which are implanted at the edge of the tumor. This may cause an unnecessarily high dose to the outer surface of the tongue, which sometimes leads to a persistent ulcer. To avoid this complication, we invented a modified implantation method, and applied the method to five consecutive patients.
  
  
  RESULTS
  With a minimum follow-up of 2 years, all primary tumors in 5 consecutive patients have been controlled. No complications occurred in soft tissue of the tongue or in the mandible.
  
  
  CONCLUSIONS
  Our modified Manchester System was feasible and effective for tumors that has a thickness of 1.5 cm or more.
authors.affiliation: Department of Biomedical Sciences and Engineering, Faculty of Health Sciences, Graduate School of Health Sciences, Hokkaido University, Sapporo, Japan. trout@hs.hokudai.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishioka
authors.forename: Masaharu
authors.initials: M
authors.lastname: Fujino
authors.forename: Akihiro
authors.initials: A
authors.lastname: Homma
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Yamashita
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ohmori
authors.forename: Kenichi
authors.initials: K
authors.lastname: Obinata
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shirato
authors.forename: Kenichi
authors.initials: K
authors.lastname: Notani
authors.forename: Masamichi
authors.initials: M
authors.lastname: Nishio
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy; D002588:Cesium Radioisotopes / Q000627:therapeutic use*; D006801:Humans; D008207:Lymphatic Metastasis; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D014062:Tongue Neoplasms / Q000473:pathology / Q000532:radiotherapy*
chemical_list: D002588:Cesium Radioisotopes