Interventional radiotherapy (brachytherapy) for re-irradiation of recurrent head and neck malignancies: oncologic outcomes and morbidity.

IF 2.1 4区医学 Q2 OTORHINOLARYNGOLOGY

Acta Otorhinolaryngologica Italica Pub Date : 2024-05-01 DOI:10.14639/0392-100X-suppl.1-44-2024-N2824

Francesco Bussu, Bruno Fionda, Mario Rigante, Davide Rizzo, Antonella Loperfido, Roberto Gallus, Laura Maria De Luca, Michaele Francesco Corbisiero, Valentina Lancellotta, Andrea Tondo, Andrea D'Aviero, Gian Carlo Mattiucci, Gyorgy Kovacs, Jacopo Galli, Luca Tagliaferri

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引用次数: 0

Abstract

Objective: Management of recurrent head and neck cancer (HNC) is challenging. One option in previously irradiated patients is re-irradiation using interventional radiotherapy (IRT), the modern form of brachytherapy. Re-irradiation using IRT can be delivered as an exclusive strategy for salvage or through a postoperative or perioperative approach after salvage surgery. The aim of the present study is to analyse a bicentric Italian series focusing on the use of IRT as a re-irradiation modality and assess the resulting evidence concerning oncologic outcomes and morbidity.

Methods: This is a retrospective study performed in two referral centres in Italy: Policlinico Universitario Agostino Gemelli in Rome and Azienda Ospedaliera Universitaria in Sassari. All patients who had previously received a full course of external beam RT and have been re-irradiated using high-dose-rate IRT between December 2010 and June 2023 were included. Patients were retreated either by a combination of surgery and perioperative (either endocavitary or interstitial) IRT or by exclusive interstitial IRT.

Results: Thirty-four patients were included in the present series, 2 of whom underwent more than one IRT re-irradiation. Notably, no patient reported specific IRT-related toxicities. Median follow-up, excluding patients who died of HNC, was 24.5 months. Two-year local relapse-free survival was 26%, disease-specific survival 39.1%, and overall survival 36.6%.

Conclusions: The present series is the largest reported experience of re-irradiation by IRT for HNC in Italy. The very low rate of toxicity confirms IRT as the safest re-irradiation modality. It is noteworthy to underline that IRT is a multidisciplinary strategy based on the close cooperation between surgeons and radiation oncologists during every phase, from the recommendation of treatment and implantation in the operating theatre, to its prescription and dose painting.

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用于复发性头颈部恶性肿瘤再放射治疗的介入放射治疗（近距离放射治疗）：肿瘤治疗效果和发病率。

目的：复发性头颈癌（HNC）的治疗具有挑战性。对于曾接受过放射治疗的患者，一种选择是使用介入放射治疗（IRT）（近距离放射治疗的现代形式）进行再照射。使用IRT进行再照射可作为唯一的挽救策略，也可在挽救手术后通过术后或围手术期方法进行。本研究的目的是分析意大利的双中心系列研究，重点关注使用 IRT 作为再照射方式，并评估由此产生的有关肿瘤治疗效果和发病率的证据：这是一项在意大利两家转诊中心进行的回顾性研究：方法：这是一项回顾性研究，在意大利的两家转诊中心进行：罗马的Policlinico Universitario Agostino Gemelli和萨萨里的Azienda Ospedaliera Universitaria。2010年12月至2023年6月期间，所有曾接受过完整疗程外照射RT并使用高剂量率IRT再次照射的患者均被纳入其中。患者要么通过手术和围手术期（腔内或间质）IRT联合治疗，要么只接受间质IRT治疗：本系列研究共纳入 34 例患者，其中 2 例患者接受了不止一次 IRT 再照射。值得注意的是，没有患者报告与IRT相关的特殊毒性反应。除去死于HNC的患者，中位随访时间为24.5个月。两年局部无复发生存率为26%，疾病特异性生存率为39.1%，总生存率为36.6%：本系列是意大利报告的最大规模的通过IRT再照射治疗HNC的经验。极低的毒性证实IRT是最安全的再照射方式。值得强调的是，IRT是一种多学科策略，基于外科医生和放射肿瘤专家在每个阶段的密切合作，从治疗建议、手术室植入、处方和剂量绘制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Acta Otorhinolaryngologica Italica OTORHINOLARYNGOLOGY-

CiteScore

3.40

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Acta Otorhinolaryngologica Italica first appeared as “Annali di Laringologia Otologia e Faringologia” and was founded in 1901 by Giulio Masini. It is the official publication of the Italian Hospital Otology Association (A.O.O.I.) and, since 1976, also of the Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale (S.I.O.Ch.C.-F.). The journal publishes original articles (clinical trials, cohort studies, case-control studies, cross-sectional surveys, and diagnostic test assessments) of interest in the field of otorhinolaryngology as well as clinical techniques and technology (a short report of unique or original methods for surgical techniques, medical management or new devices or technology), editorials (including editorial guests – special contribution) and letters to the Editor-in-Chief. Articles concerning science investigations and well prepared systematic reviews (including meta-analyses) on themes related to basic science, clinical otorhinolaryngology and head and neck surgery have high priority.