title: Modern head and neck brachytherapy: from radium towards intensity modulated interventional brachytherapy.
abstract: Intensity modulated brachytherapy (IMBT) is a modern development of classical interventional radiation therapy (brachytherapy), which allows the application of a high radiation dose sparing severe adverse events, thereby further improving the treatment outcome. Classical indications in head and neck (H&N) cancers are the face, the oral cavity, the naso- and oropharynx, the paranasal sinuses including base of skull, incomplete resections on important structures, and palliation. The application type can be curative, adjuvant or perioperative, as a boost to external beam radiation as well as without external beam radiation and with palliative intention. Due to the frequently used perioperative application method (intraoperative implantation of inactive applicators and postoperative performance of radiation), close interdisciplinary cooperation between surgical specialists (ENT-, dento-maxillary-facial-, neuro- and orbital surgeons), as well interventional radiotherapy (brachytherapy) experts are obligatory. Published results encourage the integration of IMBT into H&N therapy, thereby improving the prognosis and quality of life of patients.
authors.affiliation: Interdisciplinary Brachytherapy Unit, University of Lübeck/University Hospital Schleswig-Holstein Campus Lübeck, Germany.
authors.forename: György
authors.initials: G
authors.lastname: Kovács
keywords: brachytherapy; head and neck; interdisciplinary; organ preservation; systematic review
references.citation: Brachytherapy. 2004;3(4):240-5
references.pmid: 15607157
references.citation: Int J Radiat Oncol Biol Phys. 2004 Jul 1;59(3):713-24
references.pmid: 15183475
references.citation: Int J Radiat Oncol Biol Phys. 2001 Sep 1;51(1):171-5
references.pmid: 11516867
references.citation: Arch Otolaryngol Head Neck Surg. 1990 Feb;116(2):165-8
references.pmid: 2297406
references.citation: Strahlenther Onkol. 2010 Sep;186(9):511-6
references.pmid: 20803182
references.citation: Radiother Oncol. 2008 May;87(2):268-73
references.pmid: 18262672
references.citation: Jpn J Clin Oncol. 2006 Nov;36(11):681-7
references.pmid: 17020894
references.citation: Int J Radiat Oncol Biol Phys. 2001 Oct 1;51(2):354-62
references.pmid: 11567809
references.citation: Int J Radiat Oncol Biol Phys. 1996 Jan 15;34(2):497-505
references.pmid: 8567354
references.citation: Brachytherapy. 2002;1(3):149-53
references.pmid: 15090278
references.citation: Int J Radiat Oncol Biol Phys. 1994 Dec 1;30(5):1029-36
references.pmid: 7961008
references.citation: Radiother Oncol. 2011 Jan;98(1):57-62
references.pmid: 21129799
references.citation: Int J Radiat Oncol Biol Phys. 1988 May;14(5):849-53
references.pmid: 3360654
references.citation: Int J Radiat Oncol Biol Phys. 2001 Apr 1;49(5):1351-60
references.pmid: 11286843
references.citation: Brachytherapy. 2007 Apr-Jun;6(2):157-63
references.pmid: 17434110
references.citation: J Contemp Brachytherapy. 2010 Mar;2(1):9-13
references.pmid: 28031737
references.citation: Brachytherapy. 2005;4(2):154-62
references.pmid: 15893270
references.citation: Brachytherapy. 2009 Jul-Sep;8(3):284-9
references.pmid: 19446500
references.citation: Int J Radiat Oncol Biol Phys. 2011 Mar 15;79(4):1158-63
references.pmid: 21353160
references.citation: Head Neck. 2014 Jan;36(1):144-51
references.pmid: 23471843
references.citation: Int J Radiat Oncol Biol Phys. 2000 Jan 15;46(2):445-58
references.pmid: 10661353
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999 Apr;87(4):508-12
references.pmid: 10225636
references.citation: Head Neck. 2013 Apr;35(4):485-92
references.pmid: 23460243
references.citation: Strahlenther Onkol. 2001 Jul;177(7):338-44
references.pmid: 11505619
references.citation: Radiother Oncol. 2009 May;91(2):150-6
references.pmid: 19329209
references.citation: Radiother Oncol. 2001 Jan;58(1):5-6
references.pmid: 11165674
references.citation: Radiat Med. 2007 May;25(4):181-6
references.pmid: 17514370
references.citation: Int J Radiat Oncol Biol Phys. 1994 Nov 15;30(4):953-7
references.pmid: 7960998
references.citation: Int J Radiat Oncol Biol Phys. 2003 Oct 1;57(2):489-94
references.pmid: 12957261
references.citation: Int J Radiat Oncol Biol Phys. 2000 Jul 15;47(5):1311-21
references.pmid: 10889385
references.citation: Int J Radiat Oncol Biol Phys. 2004 Jul 15;59(4):983-91
references.pmid: 15234031
references.citation: Radiother Oncol. 2006 Jul;80(1):39-42
references.pmid: 16870288
references.citation: Brachytherapy. 2010 Jul-Sep;9(3):227-34
references.pmid: 20116340
references.citation: Int J Radiat Oncol Biol Phys. 1987 Jul;13(7):1113-4
references.pmid: 3597154
references.citation: Strahlenther Onkol. 2005 Feb;181(2):97-107
references.pmid: 15702298
references.citation: Brachytherapy. 2013 Sep-Oct;12(5):479-86
references.pmid: 23466362
references.citation: Cancer. 2007 May 15;109(10):2052-7
references.pmid: 17407106
references.citation: Int J Radiat Oncol Biol Phys. 1987 Jul;13(7):953-6
references.pmid: 3597157
references.citation: Brachytherapy. 2002;1(2):74-82
references.pmid: 15062174
references.citation: Radiother Oncol. 2012 Sep;104(3):300-4
references.pmid: 22300609
references.citation: Neoplasma. 2009;56(2):163-8
references.pmid: 19239332
references.citation: Int J Radiat Oncol Biol Phys. 1997 Feb 1;37(3):577-85
references.pmid: 9112456
references.citation: Otolaryngol Head Neck Surg. 1996 Dec;115(6):519-26
references.pmid: 8969757
references.citation: Int J Radiat Biol. 2002 Jul;78(7):617-23
references.pmid: 12079541
references.citation: Radiother Oncol. 1996 Nov;41(2):125-30
references.pmid: 9004354
references.citation: Laryngoscope. 2000 Jan;110(1):8-12
references.pmid: 10646707
references.citation: Semin Radiat Oncol. 2002 Jan;12(1):95-108
references.pmid: 11813154
references.citation: Laryngoscope. 1991 May;101(5):507-9
references.pmid: 1851521
references.citation: Radiother Oncol. 2012 Sep;104(3):305-11
references.pmid: 22280806
references.citation: Int J Radiat Oncol Biol Phys. 1996 Dec 1;36(5):1019-24
references.pmid: 8985022
references.citation: Brachytherapy. 2008 Oct-Dec;7(4):343-50
references.pmid: 18786864
references.citation: Int J Radiat Oncol Biol Phys. 1986 Mar;12(3):307-12
references.pmid: 3957731
references.citation: J Radiat Res. 2012 Nov 1;53(6):973-7
references.pmid: 22859564
references.citation: Brachytherapy. 2014 Mar-Apr;13(2):178-86
references.pmid: 24210698
references.citation: Brachytherapy. 2014 Nov-Dec;13(6):597-602
references.pmid: 24913434
references.citation: Int J Radiat Oncol Biol Phys. 1989 Feb;16(2):301-5
references.pmid: 2921129
references.citation: Strahlenther Onkol. 2007 Apr;183(4):211-4
references.pmid: 17406803
references.citation: Brachytherapy. 2008 Jul-Sep;7(3):267-9
references.pmid: 18635026
references.citation: Strahlenther Onkol. 1992 Mar;168(3):119-40
references.pmid: 1553617
references.citation: Front Radiat Ther Oncol. 1997;30:56-64
references.pmid: 9205885
references.citation: Strahlenther Onkol. 2009 Dec;185(12):789-98
references.pmid: 20013088
references.citation: Int J Radiat Oncol Biol Phys. 2008 Mar 1;70(3):953-60
references.pmid: 18262105
references.citation: Brachytherapy. 2013 Nov-Dec;12(6):535-41
references.pmid: 23988507
references.citation: Brachytherapy. 2009 Apr-Jun;8(2):248-254
references.pmid: 19230791
references.citation: Int J Radiat Oncol Biol Phys. 1985 Feb;11(2):399-402
references.pmid: 3972656
references.citation: Int J Radiat Oncol Biol Phys. 2005 Aug 1;62(5):1444-50
references.pmid: 16029806
references.citation: Otolaryngol Pol. 2004;58(4):721-9
references.pmid: 15603380
references.citation: Ophthalmology. 1997 Sep;104(9):1475-9
references.pmid: 9307644
references.citation: Radiat Oncol. 2013 Jul 05;8:166
references.pmid: 23829540
references.citation: Ann Otol Rhinol Laryngol. 1996 Dec;105(12):955-61
references.pmid: 8973282
references.citation: Int J Radiat Oncol Biol Phys. 1993 Aug 1;26(5):903; discussion 907
references.pmid: 8344861
references.citation: Brachytherapy. 2004;3(1):41-8
references.pmid: 15110313
references.citation: Int J Radiat Oncol Biol Phys. 1991 Aug;21(3):868
references.pmid: 1750903
references.citation: Radiother Oncol. 2006 Jun;79(3):298-303
references.pmid: 16730084
references.citation: J Contemp Brachytherapy. 2011 Mar;3(1):11-17
references.pmid: 27877195
references.citation: J Radiol Electrol Med Nucl. 1978 Nov;59(11):603-10
references.pmid: 748536
references.citation: Int J Radiat Oncol Biol Phys. 1997 Jun 1;38(3):497-506
references.pmid: 9231672
references.citation: Int J Radiat Oncol Biol Phys. 1991 Nov;21(6):1479-83
references.pmid: 1938556
references.citation: Laryngoscope. 2004 Jul;114(7):1170-6
references.pmid: 15235342
references.citation: J Clin Oncol. 2000 Jun;18(11):2219-25
references.pmid: 10829041
references.citation: J Contemp Brachytherapy. 2011 Jun;3(2):65-69
references.pmid: 27895671
references.citation: Radiother Oncol. 2002 Apr;63(1):67-74
references.pmid: 12065105
references.citation: Int J Radiat Oncol Biol Phys. 1990 Jun;18(6):1293-8
references.pmid: 2370179
references.citation: Brachytherapy. 2004;3(2):78-86
references.pmid: 15374539
references.citation: Int J Radiat Oncol Biol Phys. 2000 Jul 15;47(5):1287-97
references.pmid: 10889383
references.citation: Gan To Kagaku Ryoho. 2000 May;27 Suppl 2:287-90
references.pmid: 10895168
references.citation: PLoS One. 2013 Jun 10;8(6):e65423
references.pmid: 23762369
references.citation: Acta Otorhinolaryngol Ital. 2012 Oct;32(5):297-303
references.pmid: 23326008
references.citation: Br J Surg. 1996 Nov;83(11):1620-2
references.pmid: 9014691
references.citation: Arch Otolaryngol. 1983 Nov;109(11):727-30
references.pmid: 6639439
references.citation: Cancer Radiother. 2008 Nov;12(6-7):515-21
references.pmid: 18824384
references.citation: Tumori. 1991 Aug 31;77(4):336-8
references.pmid: 1746056
references.citation: Magy Onkol. 2008 Jun;52(2):145-50
references.pmid: 18640890
references.citation: Brachytherapy. 2013 May-Jun;12(3):228-34
references.pmid: 23466361
references.citation: Brachytherapy. 2012 Mar-Apr;11(2):137-43
references.pmid: 22104354
references.citation: Radiother Oncol. 1997 Oct;45(1):95-8
references.pmid: 9364638
references.citation: Front Radiat Ther Oncol. 1997;31:122-5
references.pmid: 9263804
references.citation: PLoS One. 2014 Mar 03;9(3):e90048
references.pmid: 24595299
references.citation: Radiother Oncol. 1997 Nov;45(2):141-8
references.pmid: 9424004
references.citation: Radiat Oncol. 2010 Jul 30;5:68
references.pmid: 20673340
references.citation: Strahlenther Onkol. 2005 Dec;181(12):762-7
references.pmid: 16362785
references.citation: J Clin Oncol. 1998 Apr;16(4):1310-7
references.pmid: 9552031
references.citation: Acta Radiol Ther Phys Biol. 1970 Oct;9(5):465-80
references.pmid: 5475353
references.citation: Int J Radiat Oncol Biol Phys. 1987 Jul;13(7):957-62
references.pmid: 3597158
references.citation: Cancer. 1983 Apr 1;51(7):1310-4
references.pmid: 6186353
references.citation: Pract Radiat Oncol. 2015 Mar-Apr;5(2):74-8
references.pmid: 25413412
references.citation: Radiother Oncol. 1996 May;39(2):117-21
references.pmid: 8735478
references.citation: Radiother Oncol. 1998 Aug;48(2):209-11
references.pmid: 9783894
references.citation: Brachytherapy. 2013 Jan-Feb;12(1):1-7
references.pmid: 23167979
references.citation: Tumori. 1998 Jul-Aug;84(4):478-82
references.pmid: 9825000
references.citation: Magy Onkol. 2004;48(4):297-301
references.pmid: 15655574
references.citation: Head Neck. 2009 Dec;31(12):1610-8
references.pmid: 19536853
references.citation: Radiother Oncol. 2004 Jan;70(1):75-9
references.pmid: 15036855
references.citation: Radiat Oncol. 2014 Mar 01;9:67
references.pmid: 24581393
references.citation: Int J Radiat Oncol Biol Phys. 1997 Jul 15;38(5):995-1000
references.pmid: 9276364
references.citation: Radiother Oncol. 1991 May;21(1):39-47
references.pmid: 1852918
references.citation: J Contemp Brachytherapy. 2013 Sep;5(3):144-7
references.pmid: 24143149
references.citation: Radiat Oncol. 2006 Aug 08;1:27
references.pmid: 16895605
references.citation: J Radiat Res. 2013 Jan;54(1):1-17
references.pmid: 23179377
references.citation: Radiother Oncol. 2007 Feb;82(2):167-73
references.pmid: 17258340
references.citation: Int J Radiat Oncol Biol Phys. 2002 Apr 1;52(5):1257-63
references.pmid: 11955737
references.citation: Spec Care Dentist. 1992 Sep-Oct;12(5):219-24
references.pmid: 1308321
references.citation: Br J Radiol. 1978 Oct;51(610):814-20
references.pmid: 709023
references.citation: Radiother Oncol. 1992 Jan;23(1):6-15
references.pmid: 1736334
references.citation: Brachytherapy. 2013 Nov-Dec;12(6):528-34
references.pmid: 23850275
references.citation: Cancer. 1977 Jul;40(1):145-51
references.pmid: 880547
references.citation: Strahlenther Onkol. 1996 Sep;172(9):469-74
references.pmid: 8830809
references.citation: Radiat Oncol. 2013 Jul 05;8:165
references.pmid: 23826875
references.citation: Brachytherapy. 2014 Mar-Apr;13(2):187-95
references.pmid: 24211123
references.citation: Int J Radiat Oncol Biol Phys. 2008 Nov 15;72(4):1119-27
references.pmid: 18472364
references.citation: HNO. 2008 Apr;56(4):471-8
references.pmid: 18347764
references.citation: Brachytherapy. 2005;4(1):1-4; discussion 7-8
references.pmid: 15737897
references.citation: Int J Radiat Oncol Biol Phys. 1994 Jul 1;29(4):673-9
references.pmid: 8040012
references.citation: Radiother Oncol. 1994 Dec;33(3):195-203
references.pmid: 7716260
references.citation: J Contemp Brachytherapy. 2009 Mar;1(1):62-66
references.pmid: 27799956
references.citation: Int J Radiat Oncol Biol Phys. 1999 Sep 1;45(2):367-71
references.pmid: 10487557
references.citation: Brachytherapy. 2002;1(1):11-20
references.pmid: 15062182
references.citation: Laryngoscope. 1999 Dec;109(12):1967-73
references.pmid: 10591356
references.citation: J Am Dent Assoc. 1966 Apr;72(4):862-6
references.pmid: 5324314
references.citation: Brachytherapy. 2014 Jul-Aug;13(4):405-12
references.pmid: 24818781
references.citation: Ann Otol Rhinol Laryngol. 1956 Sep;65(3):723-35
references.pmid: 13363232
references.citation: J Clin Oncol. 2008 Dec 1;26(34):5518-23
references.pmid: 18936479
references.citation: World J Surg Oncol. 2013 Mar 08;11:60
references.pmid: 23496973
references.citation: Radiother Oncol. 2001 Jan;58(1):71-5
references.pmid: 11165684
references.citation: Int J Radiat Oncol Biol Phys. 1991 Aug;21(3):868-9
references.pmid: 1869480
references.citation: Int J Radiat Oncol Biol Phys. 2008 Feb 1;70(2):361-7
references.pmid: 17892917
references.citation: Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Jan;113(1):118-25
references.pmid: 22677692
references.citation: Radiother Oncol. 2011 Mar;98(3):352-6
references.pmid: 21262547