title: Role of high dose rate interstitial brachytherapy in early and locally advanced squamous cell carcinoma of buccal mucosa.
abstract: BACKGROUND
  The study aimed to assess the effect of High Dose Rate (HDR) Interstitial Brachytherapy when used alone or in combination with External Beam Radiotherapy (EBRT), in early and locally advanced squamous cell carcinoma of buccal mucosa.
  
  
  METHODS
  Thirty three patients with histologically proven squamous cell carcinoma of the buccal mucosa received high dose rate interstitial brachytherapy either as primary treatment or as a boost from November 2008 to April 2013. Stage I patients received interstitial brachytherapy alone to a dose of 38.50 Gy, 3.5 Gy per fraction, twice daily at six hours apart for 11 fractions. Stage II patients received EBRT to a dose of 50 Gy in 25 fractions of two Gy each followed by brachytherapy boost to 21 Gy, 3.5 Gy per fraction, twice daily at six hours apart for six fractions. Stage III patients received the same radiotherapy schedule (i.e., same EBRT & Brachytherapy schedule) and with addition of Injection Cisplatin 70 mg/m(2) in three divided doses every three weeks along with EBRT.
  
  
  RESULTS
  Follow up ranged from 12 to 60 months, median follow up was 26 months. Complete response was observed in 28 patients. Five patients had residual disease and were referred for surgical salvage. One patient died of disease progression. Stage I patients had 100% local control, whereas Stage II and Stage III patients had 84.6% and 80% local control respectively.
  
  
  CONCLUSIONS
  HDR Interstitial Brachytherapy used either as a primary treatment modality or as a boost in buccal mucosal cancers provides results comparable to that of surgery, with the advantages of organ preservation, better cosmetic and functional outcomes.
authors.affiliation: Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India.
authors.forename: Parthasarathy
authors.initials: P
authors.lastname: Vedasoundaram
authors.affiliation: Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India.
authors.forename: Aravind Kumar
authors.initials: AK
authors.lastname: Prasanna
authors.affiliation: Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India.
authors.forename: Reddy
authors.initials: R
authors.lastname: Ks
authors.affiliation: Radiation Oncologists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, JIPMER, Puducherry - 6, Puducherry, India.
authors.forename: Gangothri
authors.initials: G
authors.lastname: Selvarajan
authors.affiliation: Medical Physicists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Mourougan
authors.initials: M
authors.lastname: Sinnatamby
authors.affiliation: Medical Physicists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Seenisamy
authors.initials: S
authors.lastname: Ramapandian
authors.affiliation: Medical Physicists, Department of Radiotherapy, Regional Cancer Center, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Saravanan
authors.initials: S
authors.lastname: Kandasamy
keywords: Buccal mucosal cancer; High dose rate interstitial brachytherapy; Organ preservation