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Brachytherapy for recurrent head and neck cancer
1Department of Radiation Oncology, University Hospital Rotterdam-Daniel den Hoed Cancer Center/Dijkzigt Hospital, Rotterdam, The Netherlands.
Hematology/Oncology Clinics of North America
|August 5, 1999
Summary
Reirradiation can improve local tumor control for recurrent head and neck cancer (HNC) when surgery is not an option. Optimal treatment involves high doses (≥60 Gy) with small fractions, potentially using hyperbaric oxygen and advanced radiotherapy techniques.
Area of Science:
- Oncology
- Radiation Oncology
- Medical Physics
Background:
- Recurrent head and neck cancer (HNC) poses a grim prognosis when curative surgery is not feasible.
- Reirradiation offers a viable strategy to improve local tumor control in such cases.
Purpose of the Study:
- To outline optimal strategies for reirradiation in recurrent HNC.
- To emphasize the importance of dose, fractionation, and advanced techniques for effective treatment.
Main Methods:
- Discusses the necessity of a minimum dose of 60 Gy for reirradiation.
- Highlights the preference for brachytherapy (BT) and small fraction sizes based on radiobiological principles.
- Mentions the potential role of hyperbaric oxygen to mitigate reirradiation morbidity.
Main Results:
- Reirradiation can achieve substantial local tumor control.
- Advanced imaging and conformal radiotherapy techniques (3D planning, IMRT, stereotactic radiotherapy) are crucial.
- These techniques allow for high tumoricidal doses while minimizing normal tissue irradiation.
Conclusions:
- Reirradiation is a critical option for recurrent HNC, requiring careful planning and execution.
- Utilizing advanced radiotherapy and considering adjuncts like hyperbaric oxygen can optimize outcomes.
- Minimizing irradiated normal tissue volume is paramount to reduce toxicity.