title: Reirradiation of recurrent head and neck cancer using high-dose-rate brachytherapy.
abstract: The aim of the present study was to evaluate the results of hypofractionated accelerated CT-guided interstitial HDR-BRT using 2.5 Gy per fraction. From December 2008 to March 2010, 30 patients were treated for recurrence of previously-irradiated head and neck cancer. Thirteen patients underwent surgical resection followed by HDR-BRT to the tumour bed. Seventeen patients were treated with HDR-BRT only. All patients received 2.5 Gy twice per day for a total dosage of 30 Gy. The overall survival rate (OS) for the entire group at 1 and 2-years was 63% and 47%, while local control (LC) was 73% and 67%, and disease-free survival (DFS) was 60% and 53%, respectively. Patients treated with surgical resection and HDR-BRT showed an improvement in both 2-year LC (77% vs. 47%, p = 0.013) and 2-year OS (62% vs. 35%, p = 0.035) compared to patients treated with HDR-BRT only. Median OS for pre-treatment tumour volumes ≤ 36 cm3 was 22 months and 9.2 months for those > 36 cm3 (p = 0.038). Grade III and IV late complications occurred in 3% of patients. There were no grade V complications. The interstitial HDR brachytherapy regimen using 2.5 Gy twice daily fractions at a total dose of 30 Gy offers an effective treatment option for patients with recurrent previously-irradiated head and neck cancer with a low rate of late high grade toxicity. Surgical resection had a positive effect on survival and local control in management of patients with recurrent head and neck cancer.
authors: Lithuanian University of Health Sciences, Oncology Institute, Kaunas, Lithuania. wictoras@hotmail.com
authors: V
authors: V
authors: Rudzianskas
authors: A
authors: A
authors: Inciura
authors: E
authors: E
authors: Juozaityte
authors: M
authors: M
authors: Rudzianskiene
authors: R
authors: R
authors: Kubilius
authors: S
authors: S
authors: Vaitkus
authors: M
authors: M
authors: Kaseta
authors: D
authors: D
authors: Adliene
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000379:methods*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy*; D011829:Radiation Dosage; D019233:Retreatment; D015996:Survival Rate
keywords: HDR brachytherapy; Head and neck cancer; Reirradiation