Simple fabrication technique of personalized endocavitary brachytherapy applicator for maxillary alveolar cancer

Warren Bacorro; Janell Marie Genson; Audri Joelle Dueñas; Henri Cartier Co; Antonio Villalon; Alfredo Pontejos

doi:10.5114/jcb.2023.133069

eISSN: 2081-2841
ISSN: 1689-832X

Journal of Contemporary Brachytherapy

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6/2023
vol. 15

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abstract:

Case report

Simple fabrication technique of personalized endocavitary brachytherapy applicator for maxillary alveolar cancer

Warren Bacorro

^{1, 2}

,

Janell Marie Genson

¹

,

Audri Joelle Dueñas

¹

,

Henri Cartier Co

¹

,

Antonio Villalon

³

,

Alfredo Pontejos

⁴

Department of Radiation Oncology, Manila Doctors Hospital, Ermita, Manila, Philippines
Department of Clinical Epidemiology, Faculty of Medicine and Surgery, University of Santo Tomas, Sampaloc, Manila, Philippines
Section of Medical Oncology, Department of Internal Medicine, Manila Doctors Hospital, Ermita, Manila, Philippines
Department of Otorhinolaryngology and Head and Neck Surgery, Manila Doctors Hospital, Ermita, Manila, Philippines

J Contemp Brachytherapy 2023; 15, 6: 470–475

DOI: https://doi.org/10.5114/jcb.2023.133069

Online publish date: 2023/11/20

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Purpose:
We report on methods and outcomes of post-operative endocavitary brachytherapy after prior irradiation and salvage surgery in a patient with maxillary alveolar squamous cell carcinoma (SCC).

Material and methods:
A 67-year-old male with right maxillary alveolar SCC was referred for brachytherapy after prior definitive chemoradiotherapy and salvage posterior maxillectomy. A personalized endocavitary applicator was fabricated using dental impression plastic tray, vinyl polysiloxane paste, and four flexible catheters to deliver fourteen 3.5 Gy high-dose-rate fractions. High-risk and intermediate-risk clinical target volumes were treated to 3.7 Gy (D₉₀) and 2.4 Gy (D₉₈), with mandibular dose limited to 2.3 Gy (D_2cc) per fraction. These corresponded to total 2 Gy equivalent doses (EQD₂) of 72.8 Gy, 40.5 Gy, and 34 Gy, respectively.

Results:
The patient developed grade 2 mucositis and was disease-free for six months. He had biopsy-confirmed local recurrence at 8 months. He refused further treatment and expired within a month.

Conclusions:
This simple approach to a personalized endocavitary applicator is feasible and allows for lower costs and less treatment delays, while ensuring patient comfort and convenience.

keywords:

Simple fabrication technique of personalized endocavitary brachytherapy applicator for maxillary alveolar cancer

Warren Bacorro 1, 2 , Janell Marie Genson 1 , Audri Joelle Dueñas 1 , Henri Cartier Co 1 , Antonio Villalon 3 , Alfredo Pontejos 4

case report, alveolar cancer, endocavitary brachytherapy, high-dose-rate, re-irradiation

Warren Bacorro

^{1, 2}

,

Janell Marie Genson

¹

,

Audri Joelle Dueñas

¹

,

Henri Cartier Co

¹

,

Antonio Villalon

³

,

Alfredo Pontejos

⁴