eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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vol. 11
Case report

A new implant device to prevent edema-associated underdosage in high-dose-rate interstitial brachytherapy of mobile tongue cancer

Ken Yoshida
Tadayuki Kotsuma
Hironori Akiyama
Hideya Yamazaki
Tadashi Takenaka
Koji Masui
Yutaka Tsujimoto
Naoya Murakami
Yasuo Uesugi
Taiju Shimbo
Nobuhiko Yoshikawa
Hiroto Yoshioka
Mio Nakata
Takumi Arika
Yuji Takaoka
Eiichi Tanaka
Nikolaos Tselis

J Contemp Brachytherapy 2019; 11, 6: 573–578
Online publish date: 2019/12/25
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Tongue edema is a potential cause of treatment target underdosage in high-dose-rate interstitial brachytherapy (HDR-ISBT) of mobile tongue cancer. To prevent such edema-associated alteration of dosimetry, we developed a special silicon device. In this report we communicate our initial experience with two mobile tongue cancer patients whom we treated using this new device.

Material and methods
The device consists of silicone tubes with a fixed width and scalable length depending on tongue size. These tubes are lined and fixed like a palisade, allowing the device to be used also as a template. The device is placed next to the lateral border of the tongue and on the floor of the mouth. In addition, a vinyl template can be placed on the dorsal tongue surface with both devices combined for implantation guidance. Between June and August 2012, two patients with locally confined tongue cancer were treated.

Between June and August 2012, two mobile tongue cancer patients classified as cT2N0M0 were treated with HDR-ISBT using the silicone device. They underwent ISBT as monotherapy with fractional doses of 6.0 Gy up to a total physical dose of 54.0 Gy. The D90 (CTV) values of both patients were 6.3 Gy and 6.6 Gy and the D2cc (mandible) values were 3.4 Gy and 2.6 Gy, respectively. At present, both patients remain without local disease recurrence at 60 and 56 months after ISBT, respectively.

The described silicone device has the potential to prevent underdosage to the treatment target related to tongue edema. It has been shown to be safe and easy to implement.


tongue edema, silicone device, high-dose-rate interstitial brachytherapy, mobile tongue cancer

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