title: American Brachytherapy Society Task Group Report: Combined external beam irradiation and interstitial brachytherapy for base of tongue tumors and other head and neck sites in the era of new technologies.
abstract: Irradiation plays an important role in the treatment of cancers of the head and neck providing a high locoregional tumor control and preservation of organ functions. External beam irradiation (EBI) results in unnecessary radiation exposure of the surrounding normal tissues increasing the incidence of side effects (xerostomy, osteoradionecrosis, and so forth). Brachytherapy (BT) seems to be the best choice for dose escalation over a short treatment period and for minimizing radiation-related normal tissue damage due to the rapid dose falloff around the source. Low-dose-rate BT is being increasingly replaced by pulsed-dose-rate and high-dose-rate BT because the stepping source technology offers the advantage of optimizing dose distribution by varying dwell times. Pulsed-dose and high-dose rates appear to yield local control and complication rates equivalent to those of low-dose rate. BT may be applied alone; but in case of high risk of nodal metastases, it is used together with EBI. This review presents the results and the indications of combined BT and EBI in carcinoma of the base of tongue and other sites of the head and neck region, as well as the role BT plays among other-normal tissue protecting-modern radiotherapy modalities (intensity-modulated radiotherapy, stereotactic radiotherapy) applied in these localizations.
authors: Center of Radiotherapy, National Institute of Oncology, Budapest, Hungary. Electronic address: takacsi@oncol.hu.
authors: Zoltán
authors: Z
authors: Takácsi-Nagy
authors: Radiotherapic Oncology Department, University of Navarra, Navarra, Spain.
authors: Rafael
authors: R
authors: Martínez-Mongue
authors: Department of Radiation Oncology, Groupe Hospitelier Pitié-Salpêtrière, Paris, France.
authors: Jean-Jacques
authors: JJ
authors: Mazeron
authors: Department of Radiation Oncology, School of Medicine, University of Utah, Salt Lake City, UT.
authors: Cristopher James
authors: CJ
authors: Anker
authors: Department of Radiation Oncology, Moffitt Cancer Center, Tampa, FL.
authors: Louis B
authors: LB
authors: Harrison
mesh_terms: D026683:Advisory Committees; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy*; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D009367:Neoplasm Staging; D010025:Osteoradionecrosis / Q000453:epidemiology / Q000209:etiology; D011832:Radiation Injuries / Q000453:epidemiology / Q000209:etiology; D018787:Radiation Oncology; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012955:Societies, Medical; D000077195:Squamous Cell Carcinoma of Head and Neck; D014062:Tongue Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D014481:United States; D014987:Xerostomia / Q000453:epidemiology / Q000209:etiology
keywords: Brachytherapy; External beam; Tongue