Case Study: A Buccal Mucosa Carcinoma Treated with High Dose Rate Brachytherapy

Abstract

Squamous cell carcinoma of the buccal mucosa is relatively rare in the United States and Western Europe. Treatment options, for early stage lesions, include surgery or external beam radiotherapy followed by a localized boost. This manuscript will present a case of early stage squamous cell carcinoma of the left buccal mucosa treated with intensity modulated radiation therapy (IMRT) followed by a high dose rate (HDR) brachytherapy boost. The decision to deliver the boost via HDR was dictated by the fact that our orthovoltage unit was unavailable at the time of treatment.
With limited literature available on HDR mold (stent) radiotherapy for oral cancer, a discussion on the issues encountered during treatment planning and delivery may prove to be insightful for facilities faced with a similar challenge. This manuscript will convey the importance of (1) careful stent construction, (2) considerations for treatment planning (i.e. CT planning (purchase of CT compatible dummy strands) versus conventional (definition of the stent surface using fluoroscopic images)) and (3) pre-treatment quality assurance of the catheters.