Purpose: Surface mould brachytherapy in oral cancers particularly, cancer of palate is an indispensible modality in dose escalation of irradiation. It also offers the advantage of high localized dose and shorter treatment time. The rapid dose fall off beyond the source having radioactivity provides with greater tumor control probability and lesser normal tissue complication probability, resulting in higher therapeutic ratio. Image guided brachytherapy has aided in this cause of radiation oncologists. However, to achieve this target the treating oncologist has to overcome many challenges through individualistic approach in treatment of each patient. In this article, we are sharing our institutional experiences regarding the challenges faced in treatment of carcinoma palate surface mould brachytherapy and possible solutions to overcome these challenges. Materials and Methods: Five patients of squamous cell carcinoma palate (T2-3, N0) who attended our institute were included in our study for radical treatment by irradiation. All patients were given a dose of 50 Gray (Gy) in 25 fractions (#) by external beam radiation therapy (EBRT). Then assessment was done by a team of radiation oncologist, medical physicist and prosthodontist for feasibility of boost by preparation of surface mould brachytherapy. The challenges faced were noted and improvisations were done as needed. Conclusion: Surface mould brachytherapy has created its special place in optimal care of patients of carcinoma palate. The skills needed to treat the patient by this modality can be always acquired and challenges can be overcome by modifications done keeping in mind the basic brachytherapy principles. The radiation oncologists should offer the patient with this modality with high therapeutic ratio for optimal patient care.

Keywords: Surface mould brachytherapy; Carcinoma palate.