title: Locally advanced verrucous carcinoma of the oral cavity: treatment using customized mold HDR brachytherapy instead of hemi-maxillectomy.
abstract: BACKGROUND
  Oral verrucous carcinomas are locally invasive but rarely metastasize. Current treatment options include surgery and external beam radiotherapy (EBRT). In medical inoperable patients or irresectable tumors, high-dose-rate (HDR) brachytherapy is a valid alternative.
  
  
  METHODS
  We present an 85-year-old man with functionally irresectable cT3N0M0 verrucous carcinoma superficially spreading along the upper alveolar ridge to the retro-alveolar triangle, with infiltration of the left soft and hard palate and buccal mucosa. Using a customized intraoral mold, this patient was treated with HDR brachytherapy delivering a dose of 48 Gy in 12 fractions three times per week. Treatment was well tolerated, and after prolonged confluent mucositis the tumor is in complete remission.
  The scarce literature on customized mold HDR brachytherapy in maxillary tumors is reviewed and recommendations for other head and neck tumors are given.
authors: Department of Radiation Oncology (MAASTRO), GROW School for Oncology and Developmental Biology, Maastricht University Medical Centre, Dr Tanslaan 12, 6229 ET, Maastricht, The Netherlands.
authors: K M J
authors: KM
authors: van Gestel
authors: D J M
authors: DJ
authors: Buurman
authors: R
authors: R
authors: Pijls
authors: P A W H
authors: PA
authors: Kessler
authors: P L A
authors: PL
authors: van den Ende
authors: A L
authors: AL
authors: Hoffmann
authors: E G C
authors: EG
authors: Troost
mesh_terms: D000369:Aged, 80 and over; D001918:Brachytherapy / Q000295:instrumentation* / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D009062:Mouth Neoplasms / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D009361:Neoplasm Invasiveness; D019647:Oral Surgical Procedures; D016896:Treatment Outcome
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