Novel high dose rate lip brachytherapy technique to improve dose homogeneity and reduce toxicity by customized mold

Jon Feldman, Limor Appelbaum, Mordechay Sela, Ninel Voskoboinik, Sarit Kadouri, Jeffrey Weinberger, Itzhak Orion, Amichay Meirovitz

Research output: Contribution to journalArticlepeer-review

10 Scopus citations


Purpose/Objectives: The purpose of this study is to describe a novel brachytherapy technique for lip Squamous Cell Carcinoma, utilizing a customized mold with embedded brachytherapy sleeves, which separates the lip from the mandible, and improves dose homogeneity. Materials and methods: Seven patients with T2 lip cancer treated with a "sandwich" technique of High Dose Rate (HDR) brachytherapy to the lip, consisting of interstitial catheters and a customized mold with embedded catheters, were reviewed for dosimetry and outcome using 3D planning. Dosimetric comparison was made between the "sandwich" technique to "classic" - interstitial catheters only plan. We compared dose volume histograms for Clinical Tumor Volume (CTV), normal tissue "hot spots" and mandible dose. We are reporting according to the ICRU 58 and calculated the Conformal Index (COIN) to show the advantage of our technique. Results: The seven patients (ages 36-81 years, male) had median follow-up of 47 months. Four patients received Brachytherapy and External Beam Radiation Therapy, 3 patients received brachytherapy alone. All achieved local control, with excellent esthetic and functional results. All patients are disease free. Conclusion: The CMS technique significantly reduces the high dose volume and increases treatment homogeneity. This may reduce the potential toxicity to the lip and adjacent mandible, and results in excellent tumor control, cosmetic and functionality.

Original languageEnglish
Article number271
JournalRadiation Oncology
Issue number1
StatePublished - 23 Dec 2014


  • Brachytherapy
  • Customized mold technique
  • HDR
  • Lip
  • SCC

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging


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