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.



中文翻译：

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上颌牙槽癌个性化腔内近距离放射治疗器的简易制作技术

目的：
我们报告上颌牙槽鳞状细胞癌 (SCC) 患者在先前照射和抢救手术后进行术后腔内近距离放射治疗的方法和结果。

材料和方法：
一名患有右上颌牙槽鳞状细胞癌的 67 岁男性，在接受了明确的放化疗和挽救性后上颌切除术后，被转诊接受近距离放射治疗。使用牙科印模塑料托盘、乙烯基聚硅氧烷糊剂和四个柔性导管制造了个性化的腔内施用器，以输送 14 个 3.5 Gy 高剂量率分数。高风险和中风险临床靶区的治疗剂量为 3.7 Gy (D ₉₀ ) 和 2.4 Gy (D ₉₈ )，下颌剂量限制为每次分次 2.3 Gy (D _2cc )。这些分别对应于72.8Gy、40.5Gy和34Gy的总2Gy当量剂量(EQD _{2 )。}

结果：
患者出现 2 级粘膜炎，六个月内无病。8 个月时，他的活检证实局部复发。他拒绝进一步治疗，并在一个月内去世。

结论：
这种简单的个性化腔内涂药器方法是可行的，可以降低成本并减少治疗延误，同时确保患者的舒适度和便利性。