title: Salvage for cervical recurrences of head and neck cancer with dissection and interstitial high dose rate brachytherapy.
abstract: 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.
authors.affiliation: Radiation Oncology Department, Centro de Tratamento e Pesquisa, Hospital ACCamargo, São Paulo, Brazil. cpellizzon@walla.com
authors.forename: Antonio Cassio Assis
authors.initials: AC
authors.lastname: Pellizzon
authors.forename: João Victor
authors.initials: JV
authors.lastname: Salvajoli
authors.forename: Luiz Paulo
authors.initials: LP
authors.lastname: Kowalski
authors.forename: Andre Lopes
authors.initials: AL
authors.lastname: Carvalho
mesh_terms: 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