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Strahlentherapie und Onkologie

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01.06.2015 | Original Article

Reirradiation for recurrent head and neck cancer with salvage interstitial pulsed-dose-rate brachytherapy

Long-term results

verfasst von: Prof. Dr. med. Vratislav Strnad, Dr. Michael Lotter, Stephan Kreppner, Prof. Dr. med. Rainer Fietkau

Erschienen in: Strahlentherapie und Onkologie | Ausgabe 6/2015

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Abstract

Purpose

To assess the long-term results of protocol-based interstitial pulsed-dose-rate (PDR) brachytherapy as reirradiation combined with simultaneous chemotherapy and interstitial hyperthermia in selected patients with recurrent head and neck tumors.

Materials and methods

A total of 104 patients with biopsy-proven recurrent head and neck cancer were treated with interstitial PDR brachytherapy. Salvage surgery had also been undergone by 53/104 (51 %) patients (R1 or R2 resection in > 80 % of patients). Salvage brachytherapy alone was administered in 81 patients (78 %), with a median total dose of 56.7 Gy. Salvage brachytherapy in combination with external beam radiotherapy (EBRT) was performed in 23/104 patients (32 %), using a median total dose of D_REF = 24 Gy. Simultaneously to PDR brachytherapy, concomitant chemotherapy was administered in 58/104 (55.8 %) patients. A single session of interstitial hyperthermia was also used to treat 33/104 (31.7 %) patients. The analysis was performed after a median follow-up of 60 months.

Results

Calculated according to Kaplan–Meier, local tumor control rates after 2, 5, and 10 years were 92.5, 82.4, and 58.9 %, respectively. Comparing results of salvage PDR brachytherapy with or without simultaneous chemotherapy, the 10-year local control rates were 76 vs. 39 % (p= 0014), respectively. No other patient- or treatment-related parameters had a significant influence on treatment results. Soft tissue necrosis or bone necrosis developed in 18/104 (17.3 %) and 11/104 (9.6 %) patients, respectively, but only 3 % of patients required surgical treatment.

Conclusion

PDR interstitial brachytherapy with simultaneous chemotherapy is a very effective and, in experienced hands, also a safe treatment modality in selected patients with head and neck cancer in previously irradiated areas.

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Titel: Reirradiation for recurrent head and neck cancer with salvage interstitial pulsed-dose-rate brachytherapy
Long-term results
verfasst von: Prof. Dr. med. Vratislav Strnad
Dr. Michael Lotter
Stephan Kreppner
Prof. Dr. med. Rainer Fietkau
Publikationsdatum: 01.06.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: Strahlentherapie und Onkologie / Ausgabe 6/2015
Print ISSN: 0179-7158
Elektronische ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-014-0809-8

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Reirradiation for recurrent head and neck cancer with salvage interstitial pulsed-dose-rate brachytherapy

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Abstract

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Materials and methods

Results

Conclusion

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