Intensity modulated perioperative HDR brachytherapy for recurrent and/or advanced head and neck metastases

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• 作者：Ingo U. Teudt ; György Kovàcs ; Matthias Ritter…
• 刊名：European Archives of Oto-Rhino-Laryngology
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：273
• 期：9
• 页码：2707-2715
• 全文大小：641 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Otorhinolaryngology
  Neurosurgery
  Head and Neck Surgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1434-4726
• 卷排序：273

文摘

Recurrent neck metastases following surgery and full dose adjuvant radiotherapy of squamous cell head and neck cancer remain a clinical challenge. After revision neck dissection and chemotherapy re-irradiation dosage is often limited and survival prognosis deteriorates. Here, adjuvant high-dose rate intensity modulated perioperative brachytherapy (HDR IMBT) offers a second full radiation dose with a limited volume of normal tissue radiation in the neck. In this retrospective study patients were identified who underwent revision surgery and perioperative HDR IMBT for recurrent neck metastases. Survival rates were estimated and the scarce literature on interstitial brachytherapy of the neck was reviewed. From 2006 to 2014, nine patients were treated for recurrent or palliative neck metastases using salvage surgery and HDR IMBT. Eight patients received previous surgery and external beam radiotherapy with or without chemotherapy. Two and five year overall survival was calculated to be 78 and 67 %, respectively. HDR IMBT is a salvage treatment option for selected cases in the neck following surgical revision or last-line treatment strategies. In the literature and this small cohort radiation toxicity and the risk of “carotid blow-out” seemed to be low.KeywordsHead and neck cancerRecurrent neck metastasesIntensity modulated brachytherapy