Salvage for cervical recurrences of head and neck cancer with dissection and interstitial high dose rate brachytherapy.
Salvage therapy in head and neck cancer (HNC) is a controversy issue and the literature is scarce regarding the use of interstitial high-dose rate brachytherapy (I-HDR) in HNC. We evaluated the long-term results of a treatment policy combining salvage surgery and I-HDR for cervical recurrences of HNC. Charts of 21 patients treated from 1994 to 2004 were reviewed. The crude local control rate for all patients was 52.4%. The 5- and 8-years overall (OS) and local relapse-free survival (LRFS) rates were 50%, 42.9%, 42.5% and 28.6%, respectively. The only predictive factor associated to LFRS and OS was negative margin status (p = 0.0007 and p = 0.0002). We conclude that complete surgery is mandatory for long term control and the doses given by brachytherapy are not high enough to compensate for microscopic residual disease after surgery.
Pellizzon
Antonio Cassio Assis
AC
Radiation Oncology Department, Centro de Tratamento e Pesquisa, Hospital ACCamargo, São Paulo, Brazil. cpellizzon@walla.com
Salvajoli
João Victor
JV
Kowalski
Luiz Paulo
LP
Carvalho
Andre Lopes
AL
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011874:Radiometry / Q000379:methods; D011879:Radiotherapy Dosage; D012008:Recurrence; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome