14 Nasopharynx Cancer

Nasopharynx Cancer

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THE GEC ESTROHANDBOOKOF BRACHYTHERAPY | Part II Clinical Practice Version 1 - 10/09/2019

Figure 2. Clinical tumour volumes, organs at risk and typical isodoses with intracavitary brachytherapy using the Rotterdam applicator. Shaded areas: Red, gross tumour volume; blue violet, nasopharynx; light orange, soft palate; dark orange, brainstem; atlanto-axial joint, yellow. Lines: Light pink, 250% isodose; dark pink, 150%; red, 100%; yellow, 90%; green, 75%; blue: 40%. [Bacorro, 2018]

Figure 1. Sagittal anatomical topography on co-registered radiological images; MRI (upper), CT, with applicator in place (lower). Nasopharyngeal tumour, red; Nasopharynx, blue green; Soft palate, light orange; Brainstem, dark orange; Spinal Cord, blue.

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Figure 4. Orthogonal radiographs of inserted mould nasopharyngeal applicator. Left: lateral view; right: anteroposterior view. [Mazeron, 2002]

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Figure 3. Retrograde insertion of the mould applicator. A, A personalized mould applicator. B, Insertion of the Nelaton tubes through the nostrils. C, Recuperation of the Nelaton tubes through the mouth and fixation onto the personalized mould applicator. D, Retrograde maneuvering of the applicator into the nasopharynx by traction on the Nelaton tubes. [Mazeron, 2010]

Figure 5. Computed Tomography with the mould applicator in place. Left: coronal view; right: transverse view. [Mazeron, 2002]

Figure 6. Customized mould applicators requiring recess dissection. Left: preloading mould; Middle: afterloading mould; Right: recess dissector. [Law, 2002]