The potential uses of high-dose-rate brachytherapy in patients with head and neck cancer
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Brachytherapy has proven to be an extremely valuable method of treatment for head and neck cancer. The data supporting its application, however, is based on continuous low-dose-rate brachytherapy. To benefit from improved radiation protection, outpatient treatments, and increased patient tolerance of treatment set-up over that encountered in conventional low-dose-rate manually afterloaded brachytherapy, we implemented a high-dose-rate remote afterloading approach in selected patients with head and neck cancers. This treatment was utilized in two different roles in managing 29 patients. In its first role, it was used as the sole treatment in 13 patients with T1–2 NO malignancies. A total of ten treatments of 450–500 cGy each were delivered twice a day with a minimum of 5–6 h between treatments. With a median follow-up of 9 months, only 1 patient failed locally. In a second role, brachytherapy was applied in a post-operative adjuvant setting following wide local excision of tumors in patients who presented with recurrent disease (12 cases) or a second primary in the head and neck (4 cases). All patients had previously received external irradiation to the head and neck. Due to this previous course of irradiation, only eight treatments of 300 cGy each were delivered, for a total of 2400 cGy over a period of 4 days. However, with a follow-up of 2–16 months, only 3 patients remain disease-free.
Key wordsHead and neck cancer Brachytherapy Irradiation
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- 1.Reference deletedGoogle Scholar
- 2.Leibel SA, Scott CB, Mohiuddin M, Marcial VA, Coia LR, Davis LW, Fuks Z (1991) The effect of local-regional control on distant metastatic dissemination in carcinoma of the head and neck: results of an analysis from the RTOG head and neck database. Int J Radiat Oncol Biol Phys 21:549–556Google Scholar
- 3.Merino OR, Lindberg RD, Fletcher GH (1977) An analysis of distant metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer 40: 145–151Google Scholar
- 4.Ormsby MV, Hilaris BS, Nori D, et al (1989) Wound complications of adjuvant radiation therapy in patients with soft tissue sarcomas. Ann Surg 210:93–99Google Scholar
- 5.Parsons JT (1986) Time-dose-volume relationships in radiation therapy. In: Million R, Cassisi NJ (eds) Management of head and neck cancer, 1st edn. Lippincott, Philadelphia, pp 137–172Google Scholar
- 6.Roman TN, Souhami L, Freeman CR, Pla C, Evans MDC, Podgorsak EB, Mendelew K (1984) High dose rate afterloading intracavitary therapy in carcinoma of the cervix. Int J Radiat Oncol Biol Phys 20:921–926Google Scholar