Radiant advances: The future of brachytherapy in oral oncology

Brachytherapy has become integral to the treatment of oral cancers, offering the advantage of delivering high doses of radiation directly to tumors while minimizing exposure to surrounding healthy tissues. This review examines recent advancements that have significantly improved the precision and effectiveness of brachytherapy. The integration of high-resolution imaging technologies, such as MRI and CT scans, has enhanced tumor delineation, enabling more accurate placement of radioactive sources. Innovations in radioactive sources, particularly high-dose-rate (HDR) brachytherapy, have optimized radiation delivery, leading to shorter treatment durations and improved patient outcomes. Personalized treatment approaches, guided by genomic and molecular profiling, allow for customized dosimeter, maximizing therapeutic effectiveness while minimizing toxicity. Additionally, combining brachytherapy with other treatment modalities such as surgery, external beam radiation therapy (EBRT), and chemotherapy has demonstrated synergistic benefits, improving local control and reducing recurrence rates. Despite its advantages, brachytherapy faces challenges, including the invasive nature of the procedure, the need for specialized equipment and training, and limitations related to tumor size. Future directions in the field include advancements in imaging and dosimeter, the development of robotic-assisted brachytherapy, and more personalized treatment plans. These innovations promise to refine brachytherapy further and expand its applicability. This review highlights the transformative potential of recent advances in brachytherapy, emphasizing its evolving role in the localized treatment of oral cancers. • Enhanced Precision: Advances in MRI and CT scans have improved tumor delineation and radioactive source placement in brachytherapy, leading to better outcomes and less damage to healthy tissues. • HDR Optimization: High-dose-rate (HDR) brachytherapy allows for higher radiation doses in shorter times, improving tumor control and patient safety. • Personalized Approaches: Genomic profiling enables customized brachytherapy dosimetry, optimizing radiation delivery for each patient while minimizing toxicity. • Multimodal Integration: Combining brachytherapy with surgery, EBRT, and chemotherapy enhances local control and reduces recurrence in oral cancers. • Future Prospects: Innovations like robotic-assisted brachytherapy and advanced dosimetry aim to overcome current limitations, expanding its use in oral cancer treatment.