Role of high-dose-rate interstitial brachytherapy in head and neck cancer and lower abdominal scar recurrence

High-Dose-Rate Interstitial Brachytherapy (HDR ISBT) is effective treatment option for recurrent head and neck Cancers and Lower Abdominal Scar Recurrence. Brachytherapy delivers radiation to a localized area around the radiation source, which is away from healthy tissue hence reducing the toxicity of normal surrounding tissue. Patients with localised oral cavity cancer and localised Lower Abdominal Scar Recurrence are one of the good indications for interstitial brachytherapy. From October 2023 to August 2024, we had taken two cases of recurrent head and neck cancer patients and one case of Lower Abdominal Scar Recurrence with CA Vault primary for HDR ISBT. Average size of lesion was 6 cm. All patients were either surgically ineligible or defer from surgery. In all patients stainless steel brachytherapy needles were inserted by free hand and replaced with plastic catheters. The average numbers of needles were 4 in head and neck cancer and 9 in Lower Abdominal Scar Recurrence patients. Average dose of interstitial brachytherapy was 30Gy in 5 fractions, 6Gy per fraction, BID at least 6 hours apart was delivered. Needles were removed just after treatment and patient were discharged next day of treatment completion. All patients are currently under follow up and performing well. In all cases >60% shrinkage of tumour volume in first follow up at one month and complete regression of tumour was observed after 3 months. 2 patients had developed grade-1 skin toxicity and one patient of abdominal scar recurrence develop grade 3 skin reaction. High dose rate of interstitial brachytherapy is minimally invasive safe and feasible treatment option with minimal complication for inoperable and recurrent head and neck cancer and Lower Abdominal Scar Recurrence. (author)