Intraoperative single fraction high-dose-rate brachytherapy for head and neck cancers.
OBJECTIVE
To report on the use of single fraction high-dose-rate brachytherapy in delivering localized intraoperative radiation therapy to sites in the head and neck region inaccessible to intraoperative electron beam radiotherapy (IOERT).


METHODS
After maximal surgical resection, 7.5-20 Gy intraoperative high-dose-rate brachytherapy (IOHDR) was delivered to 65 patients using custom-made surface applicators.


RESULTS
The 1-, 3-, and 5-year local control rates for the entire group were 77%, 69%, and 59%, respectively. The 1-, 3-, and 5-year overall survival rates were 83%, 63%, and 42%, respectively, with a median overall survival of 50 months. There were no major intraoperative or postoperative complications.


CONCLUSIONS
IOHDR can be used to treat selected locally advanced head and neck tumors arising at sites inaccessible to IOERT or at institutions not using IOERT. A prospective multi-institutional study with a larger number of patients treated with IOHDR is needed to firmly establish the efficacy of IOHDR in this population group.
Nag
Subir
S
Division of Radiation Oncology, The Arthur G. James Cancer Hospital and Research Institute, The Ohio State University, Columbus, OH 43210, USA. nag.1@osu.edu
Koc
Mehmet
M
Schuller
David E
DE
Tippin
Douglas
D
Grecula
John C
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods* / Q000706:statistics & numerical data; D002648:Child; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D007430:Intraoperative Care / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009820:Ohio / Q000453:epidemiology; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D015996:Survival Rate; D016896:Treatment Outcome