Brachytherapy results in better dose distribution compared with other treatments because of steep
dose reduction in the surrounding normal tissues. Excellent local control rates and acceptable side effects have been demonstrated with
brachytherapy as a sole treatment modality, a postoperative method, and a method of
reirradiation. Low-dose-rate (LDR)
brachytherapy has been employed worldwide for its superior outcome. With the advent of technology, high-dose-rate (HDR)
brachytherapy has enabled health care providers to avoid radiation exposure. This
therapy has been used for treating many types of
cancer such as gynecological
cancer, breast cancer, and
prostate cancer. However, LDR and pulsed-dose-rate interstitial brachytherapies have been mainstays for
head and neck cancer. HDR
brachytherapy has not become widely used in the
radiotherapy community for treating
head and neck cancer because of lack of experience and biological concerns. On the other hand, because HDR
brachytherapy is less time-consuming, treatment can occasionally be administered on an outpatient basis. For the convenience and safety of patients and medical staff, HDR
brachytherapy should be explored. To enhance the role of this
therapy in treatment of head and neck lesions, we have reviewed its outcomes with
oral cancer, including Phase I/II to Phase III studies, evaluating this technique in terms of safety and efficacy. In particular, our studies have shown that superficial
tumors can be treated using a non-invasive mold technique on an outpatient basis without adverse reactions. The next generation of image-guided
brachytherapy using HDR has been discussed. In conclusion, although concrete evidence is yet to be produced with a sophisticated study in a reproducible manner, HDR
brachytherapy remains an important option for treatment of
oral cancer.