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Intensity modulated perioperative HDR brachytherapy for recurrent and/or advanced head and neck metastases

  • Head and Neck
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Abstract

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.

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Acknowledgments

The authors thank Eva Golabek and Adam Navel for editing the manuscript.

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    Authors and Affiliations

    1. Department of Otolaryngology, Head and Neck Surgery, Asklepios Klinik Altona, Paul-Ehrlich-Strasse 1, 22763, Hamburg, Germany

      Ingo U. Teudt

    2. Interdisciplinary Brachytherapy Unit, University Hospital Schleswig-Holstein, Luebeck, Germany

      György Kovàcs, Corinna Melchert & Tamer Soror

    3. Department of Otolaryngology, Head and Neck Surgery, University Hospital Schleswig-Holstein, Luebeck, Germany

      Matthias Ritter & Barbara Wollenberg

    4. Department of Otolaryngology, Head, Neck and Plastic Surgery, Asklepios Klinik St. Georg, Hamburg, Germany

      Jens E. Meyer

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    1. Ingo U. Teudt
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    Correspondence to Ingo U. Teudt.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. However, due to the retrospective type of the study no formal consent was required.

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    This article does not contain any studies with animals performed by any of the authors.

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    I. U. Teudt and G. Kovàcs contributed equally to the article.

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    Teudt, I.U., Kovàcs, G., Ritter, M. et al. Intensity modulated perioperative HDR brachytherapy for recurrent and/or advanced head and neck metastases. Eur Arch Otorhinolaryngol 273, 2707–2715 (2016). https://doi.org/10.1007/s00405-015-3794-3

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    • DOI: https://doi.org/10.1007/s00405-015-3794-3

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