High dose rate interstitial brachytherapy in patients with cancers of the head and neck

L. Yu, B. Vikram, M. Chadha, A. Alfieri, S. Mishra

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Abstract

We present our preliminary experience with fractionated high dose rate interstitial brachytherapy (HDR-IBT) in the treatment of head and neck cancers, with or without external beam irradiation, limiting the overall duration of HDR-IBT to one week or less and the maximum number of fractions to ten, delivered twice each day. We treated 12 patients with previously untreated cancers (group 1) to a total median dose of 69.5 Gy by the combination of external beam irradiation (median dose, 50.4 Gy) plus fractionated HDR-IBT (median dose, 16 Gy in six fractions). Fifteen patients with cancer that had recurred after external irradiation, surgery, or both (group 2) were treated by fractionated HDR-IBT (median dose, 28 Gy in seven fractions); seven of them also received additional external irradiation to a median dose of 40 Gy. In group 1, grade 3 or 4 morbidity occurred in none of 12 patients, while in group 2, it occurred in four (26%) of 15 patients. All complications in group 2 were seen in patients who received HDR-IBT to a total dose of 24 Gy or more (4/10 vs 0/5 at lower doses). In groups 1 and 2, the observed survival rate was 45% and 29% at two years, and the local control rate was 79% and 47%, respectively. In general, group 2 patients received lower total doses (but a greater proportion by HDR-IBT) and experienced more local failures and complications, particularly when receiving HDR-IBT doses of 24 Gy or more. In the dose range less than 24 Gy and with a fraction size of 2 to 4 Gy, HDR-IBT was shown to be safe. Our patient population was too heterogeneous to draw meaningful conclusions regarding tumor control.

Original languageEnglish (US)
Pages (from-to)1-6
Number of pages6
JournalEndocurietherapy/Hyperthermia Oncology
Volume12
Issue number1
StatePublished - Jan 1 1996

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Keywords

  • Brachytherapy
  • Head and Neck Cancer
  • High Dose Rate

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cancer Research

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