Outcomes and dosimetric analysis of reirradiation of oral cavity and oropharyngeal cancers with high-dose-rate brachytherapy

IF 1.7 4区医学 Q4 ONCOLOGY

Brachytherapy Pub Date : 2025-03-20 DOI:10.1016/j.brachy.2025.02.002

Christina Phuong, Lisa Ni, Manju Sharma, J. Adam M Cunha, Sue S. Yom, I-Chow Hsu, Jason W. Chan

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引用次数: 0

Abstract

PURPOSE

This study sought to evaluate the outcomes and toxicities from oral cavity (OC) and oropharynx (OP) high-dose-rate brachytherapy (HDRBT) for re-irradiation (reRT) of head and neck squamous cell carcinoma (HNSCC).

METHODS

Patients who previously received curative-intent external beam radiotherapy for primary HNSCC and were treated with OC/OP reRT with HDRBT from January 2000 to December 2021 were included. Patients were selected by a multidisciplinary tumor board to be appropriate candidates for HDRBT for one of two reRT indications: (1) definitive reRT or (2) postoperative reRT. Survival outcomes were estimated using the Kaplan-Meier method. Efficacy and toxicity outcomes were analyzed for the entire cohort and separately based on reRT indication.

RESULTS

27 patients were evaluated with a median follow up of 20 (IQR 12-41) mo. 14 (52%) and 13 (48%) patients were treated for a recurrent or second primary OC and OP HNSCC, respectively. Median dose of prior EBRT was 68.4 (IQR 60-70) Gy. Median interval between completion of EBRT to HDRBT reRT was 42 (IQR 14-85) mo. Median target volume was 16 (IQR 10-29) cc; median D90% was 31 (IQR 30-36) Gy. In cohorts A and B, 2-year LC/late grade ≥3 toxicity were 70%/57% and 60%/15%, respectively.

CONCLUSIONS

HDRBT for reRT of small (<4 cm), recurrent, or second primary OC/OP HNSCC provided LC and late grade ≥3 toxicity rates similar to historical outcomes with EBRT reRT.

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高剂量率近距离放射治疗口腔和口咽癌再照射的结果和剂量学分析。

目的：本研究旨在评估口腔（OC）和口咽部（OP）高剂量近距离放射治疗（HDRBT）再照射（rt）头颈部鳞状细胞癌（HNSCC）的结果和毒性。方法：纳入2000年1月至2021年12月期间接受过治疗意图外束放疗的原发性HNSCC患者，并接受了HDRBT的OC/OP ert治疗。多学科肿瘤委员会根据以下两种报告适应症之一选择患者作为HDRBT的合适候选人：(1)最终报告或(2)术后报告。使用Kaplan-Meier法估计生存结果。对整个队列的疗效和毒性结果进行分析，并根据rt适应症分别进行分析。结果：27例患者接受了中位随访，随访时间为20个月（IQR 12-41）。14例（52%）和13例（48%）患者分别接受了复发性或第二原发OC和OP性HNSCC的治疗。既往EBRT的中位剂量为68.4 Gy （IQR 60-70）。EBRT完成至HDRBT报告的中位间隔时间为42 （IQR 14-85）个月。中位靶体积为16 (IQR 10-29) cc；中位D90%为31 (IQR 30-36) Gy。在队列A和B中，2年LC/晚期≥3级毒性分别为70%/57%和60%/15%。结论：HDRBT对小(

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来源期刊

Brachytherapy 医学-核医学

CiteScore

3.40

自引率

21.10%

发文量

119

审稿时长

9.1 weeks

期刊介绍： Brachytherapy is an international and multidisciplinary journal that publishes original peer-reviewed articles and selected reviews on the techniques and clinical applications of interstitial and intracavitary radiation in the management of cancers. Laboratory and experimental research relevant to clinical practice is also included. Related disciplines include medical physics, medical oncology, and radiation oncology and radiology. Brachytherapy publishes technical advances, original articles, reviews, and point/counterpoint on controversial issues. Original articles that address any aspect of brachytherapy are invited. Letters to the Editor-in-Chief are encouraged.