Advances in Head-and-Neck Interventional Radiotherapy (Brachytherapy)

Abstract

Interventional radiotherapy, also known as brachytherapy, is the use of sealed radioactive sources that directly deliver radiation to the tumor or tumor bed. Its unique dose distribution profile allows for high conformality, making it a very useful modality in the treatment of cancers in the head and neck, where different organs and substructures that serve various but related functions are situated close to each other.

In recent years, we have seen several important technological breakthroughs in the field, especially regarding its application in head and neck cancers. These include advances in treatment delivery, dosimetry planning image guidance , and catheter positioning techniques . These innovations, which often require interdisciplinary interventions, have resulted in enhanced treatment accuracy, and therefore, major clinical advantages in terms of increased local control and decreased toxicity, as well as economic benefits.

In order to highlight the differences from old brachytherapy techniques, a more appropriate terminology should perhaps be adopted, to signify these advancements that resulted in new opportunities, approaches and better outcomes – interventional radiotherapy (IRT). Such a change in terminology will not only allow recognition of these advances, but also a meaningful distinction from obsolete techniques and suboptimal outcomes that are associated with traditional brachytherapy. This is very important in increasing awareness among professionals outside the field of radiation oncology.

We briefly review these recent advances, the current indications, and future directions for IRT in head-and-neck cancers.

Keywords : interventional radiotherapy, brachytherapy, head-and-neck cancers, image-guidance

  1. Kovács G. Modern head and neck brachytherapy: from radium towards intensity modulated interventional brachytherapy. J Contemp Brachytherapy . 2015 Jan;6(4):404-16. doi: 10.5114/jcb.2014.47813

  2. Tuček L, Vošmik M, Petera J. Is there still a place for brachytherapy in the modern treatment of early-stage oral cancer? Cancers (Basel) . 2022 Jan 3;14(1):222. doi: 10.3390/cancers14010222

  3. Merfeld EC, Witek ME, Francis DM, Burr AR, Wallace CR, Kuczmarska-Haas A, et al. interstitial brachytherapy for lip cancer: technical aspects to individualize treatment approach and optimize outcomes. Pract Radiat Oncol . 2023 Jul-Aug;13(4):340-5. doi: 10.1016/j.prro.2023.01.004

  4. Fionda B, Bussu F, Placidi E, Rosa E, Lancellotta V, Parrilla C, et al. Interventional radiotherapy (brachytherapy) for nasal vestibule: novel strategies to prevent side effects. J Clin Med . 2023 Sep 24;12(19):6154. doi: 10.3390/jcm12196154

  5. Fionda B, Boldrini L, D'Aviero A, Lancellotta V, Gambacorta MA, Kovács G, et al. Artificial intelligence (AI) and interventional radiotherapy (brachytherapy): state of art and future perspectives. J Contemp Brachytherapy . 2020 Oct;12(5):497-500. doi: 10.5114/jcb.2020.100384

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