A pivoting appliance for intracavitary brachytherapy in patients with reduced mouth opening

Purpose: The risks of radiotherapy to normal tissues are well known. In man y cases, a tumor patient suffering a relapse cannot undergo radiotherapy a second time. One exception may be the local application of brachytherapy. A fterloading devices allow the position of radiating materials near the site for treatment exactly according to threedimensional treatment planning. Th is report shows the technical procedure for the fabrication of an intracavi tary afterloading radiation device. Materials and Methods: A 48-year-old wo man who had received neutron radiotherapy and tumor surgery for adenoid cys tic carcinoma had to be treated for relapse. The mouth opening was limited to 15 mm. The mixing tip of a silicone impression system was used as an axi s for a pivoting appliance. Results: Two years after reradiation, the patie nt was free of relapse symptoms, although an increased limitation of mouth opening was recorded. Conclusion: Even if the mouth opening is severely lim ited after tumor surgery and/or radiation, intracavitary brachytherapy stil l can be performed in edentulous patients using a pivoting device.