Image-guided high-dose-rate interstitial brachytherapy with custom-made surface applicators for lower lip cancer as monotherapy. Technique, long-term clinical results, and quantitative dose-volume evaluation: A case series

Hironori Akiyama; Ken Yoshida; Tadayuki Kotsuma; Tadashi Takenaka; Yuji Takaoka; Masataka Nakai; Manabu Kano; Hitoshi Yoshimoto; Kentaro Ozawa; Zoltán Takácsi-Nagy; Koji Masui; Hideya Yamazaki; Yoshiko Ariji; Eiichi Tanaka

doi:10.5114/jcb.2025.147943

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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1/2025
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abstract:

Original paper

Image-guided high-dose-rate interstitial brachytherapy with custom-made surface applicators for lower lip cancer as monotherapy. Technique, long-term clinical results, and quantitative dose-volume evaluation: A case series

Hironori Akiyama

^{1, 2}

,

Ken Yoshida

^{2, 3}

,

Tadayuki Kotsuma

^{2, 4}

,

Tadashi Takenaka

⁵

,

Yuji Takaoka

^{2, 6}

,

Masataka Nakai

²

,

Manabu Kano

⁷

,

Hitoshi Yoshimoto

⁷

,

Kentaro Ozawa

⁸

,

Zoltán Takácsi-Nagy

⁹

,

Koji Masui

⁵

,

Hideya Yamazaki

⁵

,

Yoshiko Ariji

¹

,

Eiichi Tanaka

Department of Oral Radiology, Osaka Dental University, Otemae, Chuo-Ku, Osaka, Osaka, 540-0008, Japan
Department of Radiation Oncology, NHO Osaka National Hospital, Hoenzaka, Chuo-Ku, Osaka, Osaka, 540-0006, Japan
Department of Radiology, Kansai Medical University Medical Center, Fumizonocho, Moriguchi, Osaka, 570-8507, Japan
Department of Radiation Therapy, Osaka Rosai Hospital, Nagasonecho, Kitaku, Sakai, 591-8025, Japan
Department of Radiology, Kyoto Prefectural University of Medicine, Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-Ku, Kyoto, Kyoto, 602-8566, Japan
Department of Radiology, Saito Yukokai Hospital, Saitoasagi, Ibaraki, Osaka, 567-0085, Japan
Department of Oral and Maxillofacial Surgery, NHO Osaka National Hospital, Hoenzaka, Chuo-Ku, Osaka, Osaka, 540-0006, Japan
Department of Dermatology, NHO Osaka National Hospital, Hoenzaka, Chuo-Ku, Osaka, Osaka, 540-0006, Japan
Centre of Radiotherapy, National Tumor Biology Laboratory, National Institute of Oncology, Department of Oncology, Semmelweis University, Budapest, Hungary

J Contemp Brachytherapy 2025; 17, 1: 62–69

DOI: https://doi.org/10.5114/jcb.2025.147943

Online publish date: 2025/02/24

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AMA

Akiyama H, Yoshida K, Kotsuma T, et al. Image-guided high-dose-rate interstitial brachytherapy with custom-made surface applicators for lower lip cancer as monotherapy. Technique, long-term clinical results, and quantitative dose-volume evaluation: A case series. Journal of Contemporary Brachytherapy. 2025;17(1):62-69. doi:10.5114/jcb.2025.147943.

APA

Akiyama, H., Yoshida, K., Kotsuma, T., Takenaka, T., Takaoka, Y.,  & Nakai, M. et al. (2025). Image-guided high-dose-rate interstitial brachytherapy with custom-made surface applicators for lower lip cancer as monotherapy. Technique, long-term clinical results, and quantitative dose-volume evaluation: A case series. Journal of Contemporary Brachytherapy, 17(1), 62-69. https://doi.org/10.5114/jcb.2025.147943

Chicago

Akiyama, Hironori, Ken Yoshida, Tadayuki Kotsuma, Tadashi Takenaka, Yuji Takaoka, Masataka Nakai,  and Manabu Kano et al. 2025. "Image-guided high-dose-rate interstitial brachytherapy with custom-made surface applicators for lower lip cancer as monotherapy. Technique, long-term clinical results, and quantitative dose-volume evaluation: A case series". Journal of Contemporary Brachytherapy 17 (1): 62-69. doi:10.5114/jcb.2025.147943.

Harvard

Akiyama, H., Yoshida, K., Kotsuma, T., Takenaka, T., Takaoka, Y., Nakai, M., Kano, M., Yoshimoto, H., Ozawa, K., Takácsi-Nagy, Z., Masui, K., Yamazaki, H., Ariji, Y.,  and Tanaka, E. (2025). Image-guided high-dose-rate interstitial brachytherapy with custom-made surface applicators for lower lip cancer as monotherapy. Technique, long-term clinical results, and quantitative dose-volume evaluation: A case series. Journal of Contemporary Brachytherapy, 17(1), pp.62-69. https://doi.org/10.5114/jcb.2025.147943

MLA

Akiyama, Hironori et al. "Image-guided high-dose-rate interstitial brachytherapy with custom-made surface applicators for lower lip cancer as monotherapy. Technique, long-term clinical results, and quantitative dose-volume evaluation: A case series." Journal of Contemporary Brachytherapy, vol. 17, no. 1, 2025, pp. 62-69. doi:10.5114/jcb.2025.147943.

Vancouver

Akiyama H, Yoshida K, Kotsuma T, Takenaka T, Takaoka Y, Nakai M et al. Image-guided high-dose-rate interstitial brachytherapy with custom-made surface applicators for lower lip cancer as monotherapy. Technique, long-term clinical results, and quantitative dose-volume evaluation: A case series. Journal of Contemporary Brachytherapy. 2025;17(1):62-69. doi:10.5114/jcb.2025.147943.

Purpose:
This study showed long-term clinical results and quantitative dose-volume evaluation of image-guided high-dose-rate interstitial brachytherapy (IG HDR-BT) with custom-made surface applicators for lower lip cancer as monotherapy.

Material and methods:
Patients with localized lower lip cancer, who received IG HDR-BT with custom-made surface applicators as monotherapy at the NHO Osaka National Hospital between February 2012 and January 2015 were enrolled in this study. One to three applicators were implanted interstitially, and two to six were placed on tumor surface. Planning-aimed dose (PAD) was 54 Gy, 48 Gy for a recurrent case, and irradiation was delivered at 6 Gy/fraction, twice a day. Dosimetric goal was to achieve D₉₀: clinical target volume (CTV) > PAD without excessive dose to the mandible. A lead shield was placed between the gingiva and lower lip during irradiation to reduce the dose to the mandible in all but one edentulous patient. A gauze with 2% lidocaine was inserted intra-orally to reduce the dose to the upper lip and maxilla.

Results:
Six patients (T1 : T2 : T3 = 3 : 2 : 1), including one recurrent case, were enrolled in this study. The CTV was contoured on computed tomography and in two cases, magnetic resonance imaging was used as a reference for contouring. The median follow-up was 69.5 months. The primary tumor was controlled in all cases. No serious late adverse reactions were observed. The median D₉₀ (CTV) and V₁₀₀ (PAD) were 108.9% PAD and 99.3% CTV, respectively. The median D_0.1cm³ (mandible) was 3.2 Gy per fraction.

Conclusions:
IG HDR-BT with custom-made surface applicators for lower lip cancer as monotherapy showed an excellent CTV dose and acceptable doses to the mandible, with good long-term clinical results.

keywords:

Image-guided high-dose-rate interstitial brachytherapy with custom-made surface applicators for lower lip cancer as monotherapy. Technique, long-term clinical results, and quantitative dose-volume evaluation: A case series

Hironori Akiyama 1, 2 , Ken Yoshida 2, 3 , Tadayuki Kotsuma 2, 4 , Tadashi Takenaka 5 , Yuji Takaoka 2, 6 , Masataka Nakai 2 , Manabu Kano 7 , Hitoshi Yoshimoto 7 , Kentaro Ozawa 8 , Zoltán Takácsi-Nagy 9 , Koji Masui 5 , Hideya Yamazaki 5 , Yoshiko Ariji 1 , Eiichi Tanaka

lip cancer, image-guided high-dose-rate interstitial brachytherapy, custom surface applicators, long-term clinical results, quantitative dosimetry