Quality of life of oropharyngeal cancer patients treated with brachytherapy.
Brachytherapy (BT) is a highly conformal (accurate clinical target volume delineation, no planning target volume margin) radiotherapy technique; the radioactive source, guided by afterloading catheters, is implanted into the heart of the tumor. The localized high dose of radiation enables high tumor control rates and, because of rapid dose fall-off, sparing of the adjacent normal tissues. At the Erasmus Medical Center, excellent results were observed: 5-year local regional control of 84%, 5-year disease-free survival of 59%, and 5-year overall survival of 64%. Therefore, in the case of moderately sized tumors, for well-trained, skillful physicians, BT is the therapy of choice (if technically feasible). However, side effects are not totally negligible, partly because of the cumulative dose of BT and the first series of 46/2 Gy. However, patients treated with BT still have a better swallowing-related quality of life, which might improve further if summation of BT and the first series of 46/2 Gy, as well as autocontouring of the neck levels, are realized. So far, there is no significant relationship between the -quality index of the BT implants and local control/overall survival and/or quality of life.
Teguh
David N
DN
Erasmus University Medical Center-Daniel den Hoed Cancer Center, Groene Hilledijk 301, 3075 EA Rotterdam, The Netherlands.
Levendag
Peter C
PC
Kolkman-Deurloo
Inger-Karine
IK
van Rooij
Peter
P
Schmitz
Paul I M
PI
D001918:Brachytherapy / Q000009:adverse effects; D003680:Deglutition Disorders / Q000209:etiology; D006801:Humans; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000523:psychology* / Q000532:radiotherapy*; D011788:Quality of Life; D011879:Radiotherapy Dosage