A unique nasopharynx brachytherapy technique

To deliver a curative dose of radiation therapy to the nasopharynx using either external beam radiotherapy or conventional brachytherapy, it is often necessary to expose a large volume of normal tissue. Tolerance of normal tissue also limits the dose of radiation given for salvage therapy in failed nasopharyngeal carcinoma. A unique brachytherapy technique with associated treatment planning is presented as an alternative method of treatment. This technique combines a single linear cesium-137 source inserted in the nasopharynx via a modified cuffed endotracheal tube, in conjunction with a plaque of iridium-192 ribbons applied in the form of a modified upper denture appliance. This method allows additional treatment to the primary area while neither exposing more normal tissue than necessary nor exceeding tolerance doses to surrounding structures.