Institutional Experience of Interstitial Brachytherapy for Head and Neck Cancer with a Comparison of High- and Low Dose Rate Practice

Mohanti, Bidhu Kalyan; Sahai, Puja; Thakar, Alok; Sikka, Kapil; Bhasker, Suman; Sharma, Atul; Sharma, Seema; Bahadur, Sudhir

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자료유형: 학술저널

저자정보: Mohanti, Bidhu Kalyan (Department of Radiation Oncology, All India Institute of Medical Sciences) Sahai, Puja (Department of Radiation Oncology, All India Institute of Medical Sciences) Thakar, Alok (Department of Otolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences) Sikka, Kapil (Department of Otolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences) Bhasker, Suman (Department of Radiation Oncology, All India Institute of Medical Sciences) Sharma, Atul (Department of Medical Oncology, All India Institute of Medical Sciences) Sharma, Seema (Department of Radiation Oncology, All India Institute of Medical Sciences) Bahadur, Sudhir (Department of Otolaryngology and Head-Neck Surgery, All India Institute of Medical Sciences)

저널정보: 아시아태평양암예방학회 Asian Pacific journal of cancer prevention : APJCP Asian Pacific journal of cancer prevention : APJCP 제15권 제2호

발행연도: 2014.1

수록면: 813 - 818 (6page)

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Aims: To describe our institutional experience with high dose rate (HDR) interstitial brachytherapy (IBT) compared with previously reported results on the low dose rate (LDR) practice for head and neck cancer. Materials and Methods: Eighty-four patients with oral cavity (n=70) or oropharyngeal cancer (n=14) were treated with 192Ir HDR-IBT. Seventy-eight patients had stage I or II tumour. The patients treated with IBT alone (n=42) received 39-42 Gy/10-14 fractions (median=40 Gy/10 fractions). With respect to the combination therapy group (n=42), prescription dose comprised of 12-18 Gy/3-6 fractions (median=15 Gy/5 fractions) for IBT and 40-50 Gy/20-25 fractions (median=50 Gy/25 fractions) for external radiotherapy. Brachytherapy was given as 2 fractions per day 6 hours apart with 4 Gy per fraction for monotherapy and 3 Gy per fraction for combination therapy. Results: Four patients were not evaluable in the analysis of outcome. The primary site relapse rates were 23.8% (10/42) and 68.4% (26/38) in patients treated with IBT alone and combination therapy, respectively (p<0.001). Salvage surgery was performed in 19 patients. The 5-year local control rate was estimated at 62% and the disease-free survival (DFS) rate at 52% for all patients. Local control with respect to T1 and T2 tumours was 84% and 42%, respectively. Conclusions: Our present series on HDR-IBT and the previous report on LDR-IBT for head and neck cancer demonstrated similar DFS rates at 5 years (52%). The rate of regional failure in node-negative patients was <20% in both of our series. HDR-IBT offers similar results to LDR-IBT for head and neck cancer.

#Brachytherapy #head and neck cancer #high dose rate #interstitial radiotherapy #uniform dose

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