Comparison of limited-volume perioperative high-dose-rate brachytherapy and wide-field external irradiation in resected head and neck cancer
Gaztañaga M, Pagola M, Cambeiro M, Ruiz ME, Aristu J, Montesdeoca N, Alcalde J, Martínez-Monge R.
Department of Radiation, Clínica Universitaria de Navarra, University of Navarre, Navarre, Spain.
This study aimed to test the safety of using perioperative high-dose-rate brachytherapy (PHDRB) in resected head and neck cancer.
From 2000 to 2008, 97 patients received PHDRB after complete macroscopic resection. Group 1 (previously irradiated patients) received 32 to 40 Gray (Gy) of PHDRB in 8 to 10 twice-daily (bid) treatments (R0-R1 resections). Group 2 (unirradiated patients) received 16 to 24 Gy of PHDRB in 4 to 6 bid treatments (R0-R1 resections) followed by external beam irradiation (EBRT) of 45 Gy/25 daily fractions ± concomitant chemotherapy.
The median follow-up was 4.3 years. The cumulative hazard of 2-year grade ≥ 3 complications in group 1 was 45.9%, and the rate of grade ≥ 3 complications in group 2 was 24.6%. Actuarial locoregional control at 2 and 5 years for group 1 was 60.9% and for group 2, 84.1% and 79.4%.
Complications and locoregional failure rates were similar to those reported in the reference standards despite a much smaller treatment volume.
CITA DEL ARTÍCULO Head Neck. 2012 Aug;34(8):1081-8. doi: 10.1002/hed.21874. Epub 2012 Jan 20