Intensity modulated perioperative HDR brachytherapy for recurrent and/or advanced head and neck metastases.
Recurrent neck metastases following surgery and full dose adjuvant radiotherapy of squamous cell head and neck cancer remain a clinical challenge. After revision neck dissection and chemotherapy re-irradiation dosage is often limited and survival prognosis deteriorates. Here, adjuvant high-dose rate intensity modulated perioperative brachytherapy (HDR IMBT) offers a second full radiation dose with a limited volume of normal tissue radiation in the neck. In this retrospective study patients were identified who underwent revision surgery and perioperative HDR IMBT for recurrent neck metastases. Survival rates were estimated and the scarce literature on interstitial brachytherapy of the neck was reviewed. From 2006 to 2014, nine patients were treated for recurrent or palliative neck metastases using salvage surgery and HDR IMBT. Eight patients received previous surgery and external beam radiotherapy with or without chemotherapy. Two and five year overall survival was calculated to be 78 and 67 %, respectively. HDR IMBT is a salvage treatment option for selected cases in the neck following surgical revision or last-line treatment strategies. In the literature and this small cohort radiation toxicity and the risk of "carotid blow-out" seemed to be low.
Department of Otolaryngology, Head and Neck Surgery, Asklepios Klinik Altona, Paul-Ehrlich-Strasse 1, 22763, Hamburg, Germany. IngoTeudt@web.de.
Ingo U
IU
Teudt
Interdisciplinary Brachytherapy Unit, University Hospital Schleswig-Holstein, Luebeck, Germany.
György
G
Kovàcs
Department of Otolaryngology, Head and Neck Surgery, University Hospital Schleswig-Holstein, Luebeck, Germany.
Matthias
M
Ritter
Interdisciplinary Brachytherapy Unit, University Hospital Schleswig-Holstein, Luebeck, Germany.
Corinna
C
Melchert
Interdisciplinary Brachytherapy Unit, University Hospital Schleswig-Holstein, Luebeck, Germany.
Tamer
T
Soror
Department of Otolaryngology, Head and Neck Surgery, University Hospital Schleswig-Holstein, Luebeck, Germany.
Barbara
B
Wollenberg
Department of Otolaryngology, Head, Neck and Plastic Surgery, Asklepios Klinik St. Georg, Hamburg, Germany.
Jens E
JE
Meyer
D000328:Adult; D000368:Aged; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary / Q000628:therapy*; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D015996:Survival Rate
Head and neck cancer; Intensity modulated brachytherapy; Recurrent neck metastases