Image-guided interstitial high-dose-rate brachytherapy in the treatment of inoperable recurrent head and neck malignancies: An effective option of reirradiation.
In recurrent head and neck cancer, therapeutic options are limited and high-quality evidence is rare. The purpose of this report was to present our experience of CT-guided interstitial high-dose rate (HDR) brachytherapy in 4 challenging cases of inoperable recurrent head and neck cancer.



A 53-year-old man with mucosal melanoma of the paranasal sinuses, a 61-year-old man with myofibroblastic sarcoma of the nasal cavity, a 51-year-old woman with nasopharyngeal cancer, and a 44-year-old woman with orbital leiomyosarcoma were treated with reirradiation by HDR brachytherapy after previous comprehensive therapy, including full course external radiotherapy (RT).



All patients showed response to brachytherapy with 1 patient experiencing locoregional failure. The mean lesion-specific disease control was 15 months. Currently, 1 patient is alive and 3 patients died after mean 20 months after treatment.



In patients with inoperable recurrent head and neck cancer, CT-guided interstitial HDR brachytherapy can play a role in providing palliation and tumor control. © 2017 Wiley Periodicals, Inc. Head Neck 39: E61-E68, 2017.
Department of Radiotherapy and Oncology, J. W. Goethe University, Frankfurt am Main, Germany.
Nikolaos
N
Tselis
Department of Radiation Oncology, Otto von Guericke University, Magdeburg, Germany.
Efstratios
E
Karagiannis
Institute for Radiotherapy, Hirslanden Medical Center, Aarau, Switzerland.
Christos
C
Kolotas
Department of Otorhinolaryngology, J. W. Goethe University, Frankfurt am Main, Germany.
Mehran
M
Baghi
Department of Medical Physics and Engineering, Sana Klinikum Offenbach, Offenbach am Main, Germany.
Natasa
N
Milickovic
Department of Radiotherapy and Oncology, J. W. Goethe University, Frankfurt am Main, Germany.
Nikolaos
N
Zamboglou
D000328:Adult; D001918:Brachytherapy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000532:radiotherapy*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009303:Nasopharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy*; D009918:Orbital Neoplasms / Q000473:pathology / Q000532:radiotherapy; D010166:Palliative Care / Q000379:methods; D010255:Paranasal Sinus Neoplasms / Q000473:pathology / Q000532:radiotherapy; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D000069475:Re-Irradiation / Q000379:methods*; D018570:Risk Assessment; D012494:Sampling Studies; D019452:Terminally Ill; D013997:Time Factors; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
CT-guided brachytherapy; head and neck cancer; high-dose rate; palliation; reirradiation