Head and Neck

Brachytherapy for radiotherapy-resistant head and neck cancer: A review of a single center experience

Corresponding Author

Inbal Hazkani MD

[email protected]

Department of Otorhinolaryngology Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel

Send correspondence to Inbal Hazkani MD, Department of Otorhinolaryngology Head and Neck Surgery, Meir Medical Center, 59 Tshernichovsky St, Kfar Saba 44281 Israel. E-mail: [email protected]Search for more papers by this author

Naomi Rabinovics MD,

Naomi Rabinovics MD

Department of Otorhinolaryngology Head and Neck Surgery, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Dror Limon MD,

Dror Limon MD

Department of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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David Silvern PhD,

David Silvern PhD

Department of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Sion Koren PhD,

Sion Koren PhD

Department of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Tuvia Hadar MD,

Tuvia Hadar MD

Department of Otorhinolaryngology Head and Neck Surgery, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Gideon Bachar MD,

Gideon Bachar MD

Department of Otorhinolaryngology Head and Neck Surgery, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Thomas Shpitzer MD,

Thomas Shpitzer MD

Department of Otorhinolaryngology Head and Neck Surgery, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Aron Popovtzer MD,

Aron Popovtzer MD

Department of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Inbal Hazkani MD,

Corresponding Author

Inbal Hazkani MD

[email protected]

Department of Otorhinolaryngology Head and Neck Surgery, Meir Medical Center, Kfar Saba, Israel

Naomi Rabinovics MD,

Naomi Rabinovics MD

Department of Otorhinolaryngology Head and Neck Surgery, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Dror Limon MD,

Dror Limon MD

Department of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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David Silvern PhD,

David Silvern PhD

Department of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

Search for more papers by this author

Sion Koren PhD,

Sion Koren PhD

Department of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Tuvia Hadar MD,

Tuvia Hadar MD

Department of Otorhinolaryngology Head and Neck Surgery, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Gideon Bachar MD,

Gideon Bachar MD

Department of Otorhinolaryngology Head and Neck Surgery, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Thomas Shpitzer MD,

Thomas Shpitzer MD

Department of Otorhinolaryngology Head and Neck Surgery, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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Aron Popovtzer MD,

Aron Popovtzer MD

Department of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva, Israel and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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First published: 01 March 2016

https://doi.org/10.1002/lary.25938

Citations: 1

The authors have no funding, financial relationships, or conflicts of interest to disclose.

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Abstract

Objectives/Hypothesis

Despite advances in radiotherapy and chemotherapy treatments for head and neck cancers, the local failure rate is high. In most radiotherapy-resistant cases, surgery is performed; however, some cases are considered unresectable. No standard treatment for these situations has been established. In this study, we review our experience with brachytherapy (BT), which has a different biological mechanism than standard radiotherapy.

Methods

All patients received prior radiation to the recurrence area. Median high-dose radiation BT dose was 50 Gy, administered in 5 to 10 Gy fractions twice daily for 5 days. High-dose radiation was given via four to 10 catheters inserted under local anesthesia (3 patients) or general anesthesia with preventive tracheostomy (10 patients).

Results

Thirteen patients received BT from 2010 to 2014. Male:female ratio was 1.6:1, and median age was 66 years (range 23–89). Of those 13 patients, 10 patients were diagnosed with squamous cell carcinoma (SCC) of the oral cavity, two patients with SCC of the nasal mucosa, and one patient with eccrine duct carcinoma. Prior radiation dose ranged from 60 to 70 Gy. Local control was achieved in 11 of 13 patients; only 15.3% (2 of 13) had in-field recurrence. Five patients developed local out-of-field recurrence, and two developed distant metastases. Five patients are alive with no evidence of disease. No major toxicities were encountered. Two patients had severe mucositis and recovered within several weeks.

Conclusion

Brachytherapy for radiotherapy-resistant head and neck cancers is feasible with minor adverse events, which enables good local control. However, many advanced head and neck cancers develop regional or distant metastases; therefore, additional treatment should be suggested.

Level of Evidence

4. Laryngoscope, 126:2246–2251, 2016

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Volume126, Issue10

October 2016

Pages 2246-2251

Brachytherapy for radiotherapy-resistant head and neck cancer: A review of a single center experience

Abstract

Objectives/Hypothesis

Methods

Results

Conclusion

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Information

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Brachytherapy for radiotherapy-resistant head and neck cancer: A review of a single center experience

Abstract

Objectives/Hypothesis

Methods

Results

Conclusion

Level of Evidence

BIBLIOGRAPHY

Citing Literature

References

Related

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