Scientific publications

Phase I-II trial of perioperative high-dose-rate brachytherapy in oral cavity and oropharyngeal cancer

Martínez-Monge R (1), Gómez-Iturriaga A (1), Cambeiro M [SP] (1), Garrán C (1), Montesdeoca N (3), Aristu JJ [SP] (1), Alcalde J [SP]. (2)
(1) Department of Oncology, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
(2) Department of Otolaryngology, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain
(3) Department of Maxillofacial Surgery, Clínica Universitaria de Navarra, Pamplona, Navarra, Spain

Magazine: Brachytherapy

Date: Nov 28, 2008

Otorhinolaryngology Radiation Oncology

To determine the feasibility of combined perioperative high-dose-rate brachytherapy (PHDRB) and intermediate-dose external beam radiation therapy (EBRT) as an alternative to full-dose adjuvant EBRT in patients with unirradiated squamous cell cancer (SCC) of the oral cavity and oropharynx. Methods and MaterialsForty patients were treated with surgical resection and PHDRB. PHDRB dose was 4 Gy b.i.d. × 4 (16 Gy) for R0 resections and 4 Gy b.i.d. × 6 (24 Gy) for R1 resections, respectively. External beam radiotherapy (45 Gy in 25 fractions) was added postoperatively. Patients with Stage III, IVa tumors, and some recurrent cases received concomitant cisplatin–paclitaxel chemotherapy during EBRT.

The rate of protocol compliance was 97.5%. Eleven patients (27.5%) developed RTOG Grade 3 or greater toxicity. Four patients (10%) presented complications requiring a major surgical procedure (RTOG 4), and one patient died of bleeding (RTOG 5). Three complications (7.5%) occurred in the perioperative period, and 8 (20.0%) occurred more than 3 months after the completion of the treatment program. Severe complications were more frequent in posteriorly located implants than in anterior implants (p = 0.035). After a median follow-up of 50 months for living patients (range, 2.5–86.1+), the 7-year actuarial rates of local and locoregional control were 86% and 82%, respectively; and the 7-year disease-free survival and overall survival rates were 50.4% and 52.3%, respectively.

PHDRB can be integrated into the management of patients with resected cancer of the oral cavity who are candidates to receive postoperative radiation or chemoradiation. The local control and toxicity rates were similar to those expected after standard chemoradiation. PHDRB was associated with high toxicity in posterior locations, and the scheduled PHDRB dose was shifted to the closest lower level.

CITATION  Brachytherapy. 2009 Jan-Mar;8(1):26-33

you maybe interested


The Clínica is the greater private hospital with technological equipment of Spain, all in a single center.

Imagen de un PET, tecnología de vanguardia en la Clínica Universidad de Navarra


The professionals of the Clínica perform continuous research and training, always to the benefit of the patient.

Imagen profesionales de la Clínica Universidad de Navarra


Learn why we are different from other healthcare centers. Quality, speed, comfort and results.

Imagen del edificio de la Clínica Universidad de Navarra