Brachytherapy of neck metastases

Area of Science:

• Oncology
• Radiation Oncology
• Head and Neck Surgery

Background:

• Recurrent or persistent neck metastases from primary head and neck carcinoma pose a significant treatment challenge.
• Limited therapeutic options exist for patients with unresectable or previously treated neck disease.

Purpose of the Study:

• To evaluate the efficacy and safety of iridium-192 brachytherapy for recurrent or persistent neck metastases.
• To assess neck control rates and patient survival following brachytherapy.
• To identify potential indications for brachytherapy in this patient population.

Main Methods:

• Retrospective analysis of 20 patients with recurrent/persistent neck metastases treated with iridium-192 brachytherapy.
• Brachytherapy was delivered intra-operatively with neck dissection, as a boost after external beam radiotherapy, or as standalone treatment for unresectable disease.
• Patient outcomes including tumor control, survival, and complications were assessed.

Main Results:

• Nineteen patients were evaluable for neck control, with 15 achieving complete tumor clearance.
• Thirteen patients had sustained neck control at the time of death or last follow-up.
• Complications were minimal, and five patients remained alive at extended follow-up intervals.

Conclusions:

• Iridium-192 brachytherapy is an effective and safe treatment for recurrent or persistent neck metastases from head and neck carcinoma.
• It offers a valuable therapeutic option, particularly for unresectable disease, providing durable local control.
• Brachytherapy should be considered a frequently forgotten but useful last-line treatment modality.