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Intraoperative single fraction high-dose-rate brachytherapy for head and neck cancers
Subir Nag1, Mehmet Koc, David E Schuller
1Division of Radiation Oncology, The Arthur G. James Cancer Hospital and Research Institute, The Ohio State University, Columbus, OH 43210, USA. nag.1@osu.edu
Purpose:
To report on the use of single fraction high-dose-rate brachytherapy in delivering localized intraoperative radiation therapy to sites in the head and neck region inaccessible to intraoperative electron beam radiotherapy (IOERT).
Methods And Materials:
After maximal surgical resection, 7.5-20 Gy intraoperative high-dose-rate brachytherapy (IOHDR) was delivered to 65 patients using custom-made surface applicators.
Results:
The 1-, 3-, and 5-year local control rates for the entire group were 77%, 69%, and 59%, respectively. The 1-, 3-, and 5-year overall survival rates were 83%, 63%, and 42%, respectively, with a median overall survival of 50 months. There were no major intraoperative or postoperative complications.
Conclusions:
IOHDR can be used to treat selected locally advanced head and neck tumors arising at sites inaccessible to IOERT or at institutions not using IOERT. A prospective multi-institutional study with a larger number of patients treated with IOHDR is needed to firmly establish the efficacy of IOHDR in this population group.
