S96
Brachytherapy - Head & neck, skin, eye
ESTRO 2026
Tran 1 , Anh Khuu Duy Le 1 , Binh Thanh Dang 1 , Ngan Thi Kim Nguyen 1 1 Head & Neck Radiation, Oncology Hospital in Ho Chi Minh city, Ho Chi Minh, Vietnam. 2 Oncology, Pham Ngoc Thach university of Medicine, Ho Chi Minh, Vietnam Purpose/Objective: To determine the response rates, the 2-year and 5- year locoregional control (LRC), disease-free survival (DFS) and overall survival (OS) rates, as well as the early and late toxicities of radiation therapy of OTSCC. Material/Methods: From January 2016 to December 2021, we prospectively enrolled OTSCC patients admitted to Oncology Hospital in Ho Chi Minh City, Viet Nam - who refused surgery, were eligible for EBRT and/or ISBT and consented to radiation. Eligibility was validated by head-and-neck radiation oncologist tumor board. Treatment regimens included: EBRT alone 70Gy/2Gy (3D-CRT or IMRT), ISBT alone 50Gy/5Gy, or combined EBRT 50-66Gy/2Gy + ISBT boost 16-20Gy/4-5Gy. The locoregional response was assessed 3-6 months after finishing RT. Results: Sixty patients were recruited in the study. All patients had stage T1-3N0-1. The median age was 56; male/female ratio was 1.7. Thirty patients were treated with definitive EBRT (70Gy/ 2Gy), twenty-nine with combined EBRT (median 66Gy) + ISBT (median 20Gy) boost, and one with ISBT alone (50Gy/ 5Gy). At 6 months after radiation, 73% of patients achieved complete response, including one case with ISBT monobrachytherapy, 8% partial response, and 12% disease progression. The 2-yr/5-yr locoregional control, disease-free survival, and overall survival rates were 65%/60%, 60.4%/50%, and 84%/70%, respectively. The EBRT acute toxicities included dermatitis, anorexia, and mucositis; were mostly grade 1-2. The ISBT acute toxicities were limited to pain and self-limited bleeding (8%), mucositis (100%). Late toxicities included xerostomia (88%), cutaneous fibrosis (47%), trismus (2%) and mandible osteoradionecrosis (2%). Age, gender, depth of invasion, macroscopic morphology, and histologic grade, stage did not show correlation with survival outcomes. Conclusion: Both EBRT and ISBT can be an effective alternative therapy in T1-3 OTSCC. Monobrachytherapy should be highly selective for superficial lesion, while more advanced T stage tumors require EBRT with/without ISBT boost. These treatments showed relatively good local regional control, OS and DFS with tolerable toxicities. Keywords: conservative therapy, tongue cancer, interstitial
Results: Target volume coverage was 90% for both
brachytherapy (BT) and CyberKnife (CK). The mandible received a much lower dose with BT (D2cm ³ : 1.5 Gy) than CK (D2cm ³ : 18.8 Gy). For salivary glands, CK achieved lower doses on both ipsilateral and contralateral sides (ipsilateral parotid 3.18 Gy, contralateral parotid 1.67 Gy, contralateral submandibular 3.15 Gy) compared with BT (7.2 Gy, 3.6 Gy, 7.1 Gy). According to the M.D. Anderson Dysphagia Scale, all CK patients (100%, n=8) reported no swallowing difficulties at the start, end, or 2 weeks after the treatment, despite grade III radiomucositis. In contrast, all BT patients (100%, n=9) experienced swallowing difficulty, effort, and interference with eating at baseline and treatment end, which improved after 2 weeks. In EORTC QLQ-C30, CK patients rated overall quality of life 6/7 at baseline and end of treatment; at 2 weeks, four rated 3 and four rated 4. BT patients rated 3/7 at baseline and end, improving to 4–5 at 2 weeks. EORTC QLQ-H&N35 showed CK patients could eat solid foods initially, but preferred soft foods after 2 weeks; BT patients could not eat solid foods during treatment, improving to soft or finely chopped foods post 2 weeks. No aspiration or nasogastric feeding was required. Conclusion: Both brachytherapy (BT) and CyberKnife (CK) provided adequate postoperative dose distribution for tongue and floor of mouth tumors. BT optimized PTV coverage and mandible dose, while CK minimized salivary gland exposure. CK shows promise for postoperative head and neck cancer, but further
patient studies are needed. Keywords: HDR-AL, CK, BT References:
Radiol Oncol. 2023 Nov 30;57(4):516-523. doi: 10.2478/raon-2023-0050. eCollection 2023 Dec 1.Dosimetric comparison of postoperative interstitial high-dose-rate brachytherapy and modern external beam radiotherapy modalities in tongue and floor of the mouth tumours in terms of doses to critical organsÖrs Ferenczi, Tibor Major, Georgina Fröhlich, Dalma Béla, Szabolcs Tódor, Csaba Polgár, Hironori Akiyama, Botond Bukovszky, Zoltán Takácsi- NagyAffiliations Expand: PMID: 38038418, PMCID: PMC10690754 Digital Poster 940 ORAL TONGUE SQUAMOUS CELL CARCINOMA TREATMENT WITH RADIATION THERAPY Hoang Duc Lam 1 , Thi Bich Hien Nguyen 1 , Thinh Huy Quoc Dang 1 , Phuong Lan Tran 1,2 , Thien Quoc Luong 1 , Cuong Ky Nguyen 1 , Hieu Chau Nguyen 1 , Ha Anh Hai
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