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Journal of Contemporary Brachytherapy
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5/2020
vol. 12
 
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abstract:
Original paper

Brachytherapy in head and neck malignancies: Indian Brachytherapy Society (IBS) recommendations and guidelines

Rajendra Bhalavat
1
,
Ashwini Budrukkar
2
,
Sarbani Ghosh Laskar
2
,
Dayanand Sharma
3
,
Ashutosh Mukherji
4
,
Manish Chandra
1
,
Umesh Mahantshetty
2
,
Vibhay Pareek
5
,
Pratibha Bauskar
1
,
Sonali Saraf
6

  1. Department of Radiation Oncology, Jupiter Lifelines Hospital, Thane, India
  2. Department of Radiation Oncology, Tata Memorial Hospital, Parel, India
  3. Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
  4. Department of Radiation Oncology, Mahamana Pandit Madanmohan Malviya Cancer Center and Homi Bhabha Cancer Hospital, Varanasi, India
  5. Department of Radiation Oncology, National Cancer Institute, AIIMS, New Delhi, India
  6. Department of Oncoanesthesia, Jupiter Lifelines Hospital, Thane, India
J Contemp Brachytherapy 2020; 12, 5: 501–511
DOI: https://doi.org/10.5114/jcb.2020.100385
Online publish date: 2020/10/29
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Introduction
Brachytherapy (BT) forms major treatment modality in squamous cell carcinoma of head and neck cancers (HNC). However, there is a dearth of literature and guidelines for the use in various indications. High-dose-rate brachytherapy (HDR-BT) in Indian scenario is an important treatment modality, and the recommendations in this guidelines aim to provide the necessary recommendations for the use of HDR-BT for uniform application across the country in patients with HNC.

Material and methods
A panel consisting of members of the Indian Brachytherapy Society (IBS), based on their clinical experience was invited. The process involved defining important steps, precautions, target volumes and indications, thorough literature review, and discussion with fellow members. The guidelines were established and formulated the recommendations for HDR-BT based on available evidences and individual experience for sites, relevant to Indian settings.

Results
The IBS recommends the use of HDR brachytherapy as a part of treatment of head and neck tumors. The scope of these guidelines and recommendations included practical suggestions, ensuring efficient use of brachytherapy treatment as radical with external beam radiotherapy (EBRT) boost, palliative and adjuvant as definitive, or re-radiation as salvage for HNC in India. The IBS has made specific site-wise recommendations for previously untreated and recurrent HNC patients on their selection criteria, implant techniques, target volume definition, and HDR treatment parameters, such as time, dose rate, total dose, and fractionation schedules. Limited experience exists with HDR-BT in patients with head and neck cancers in India and across the globe.

Conclusions
IBS provided a consensus statement and guidelines for the head and neck brachytherapy and believed that these recommendations will overcome the fear of practicing radiation oncologists. This should generate interest amongst students and will help radiation oncologists all across the country to use the art of brachytherapy carefully in HNC patients, with better curative and salvage options.

keywords:

head and neck malignancies, HDR brachytherapy, guidelines, recommendations

  
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