A case–control study of patients with squamous cell carcinoma of the oral cavity and oropharynx treated with pulsed-dose-rate brachytherapy

Haddad, Alain; Peiffert, D.; Lapeyre, M.; Harter, Valentin; Buchheit, I.; Gräff, P.

doi:10.1016/j.brachy.2014.05.011

Cited by 13 publications

(8 citation statements)

References 19 publications

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“…In terms of local control and toxicities, the results of this cohort study were similar to those described in the literature on PDR and LDR. With LC of 87% and RC of 82% at 5 years, our study obtained results comparable with 2 series of patients with LDR-BT published in 1995 and 2014 by our institution (LC: 89% and 97%, RC: 82%) [ 3 , 6 ]. Consistent series of 36-236 patients treated with PDR-BT presented an LC rate between 88% and 97% at 3-5 years [ 3 , 7 , 8 ].…”

Section: Discussionsupporting

confidence: 84%

“…No randomized trial has compared brachytherapy with other techniques, but results obtained in large series of patients validated BT treatment for localized tumors [ 1 , 2 ]. Brachytherapy of head and neck cancers has been formerly performed using iridium wires with low-dose-rate (LDR) BT, but is progressively being replaced by pulse-dose-rate (PDR) BT, with comparable results [ 3 ]. The aim of this study was to analyze the results of patients treated in our institute from 2009 to 2020 after replacing LDR-BT with PDR-BT.…”

Section: Purposementioning

confidence: 99%

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Adjuvant pulse-dose-rate brachytherapy for oral cavity and oropharynx carcinoma: Outcome and toxicity assessment of 66 patients

Renard,

Demogeot,

Bruand

et al. 2024

jcb

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Purpose Brachytherapy (BT) is a validated radiation technique for treatment of early stage tumors of oral cavity and oropharynx. This study aimed to analyze the results of our institute’s patients after replacing low-dose-rate (LDR) with pulse-dose-rate (PDR) brachytherapy. Material and methods We retrospectively collected data from all patients treated between 2009 and 2020 for squamous cell carcinoma (floor of the mouth, tongue, and oropharynx) using adjuvant interstitial BT with or without external RT. Primary outcome was local control. Secondary outcomes were regional control rate and toxicity. Statistical analysis of local and regional recurrences were described using Kaplan-Meier method. Prognostic value of each factor for recurrence or toxicity was evaluated with bivariate Fine-Gray model. Results Data from 66 patients were analyzed. Local and regional recurrences were reported in 11% and 20% of the patients, respectively. No significant factors were identified in the present study. Grade 2 and 3 acute mucositis were reported in 21% of patients, and were more frequent in the BT only group. Almost half (47%) of the patients described acute pain following BT, and 26% required stage 2 or 3 analgesics. Trophic disorders were observed in 16 patients. Five patients presented with soft tissue necrosis (STN) and required medical treatment, of whom one subsequently required hyperbaric oxygen therapy. No predictive factors were identified for STN risk. Two patients developed osteoradionecrosis. Conclusions Oral and oropharyngeal PDR-BT as adjuvant treatment is safe and effective for well-defined indications.

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Section: Discussionsupporting

confidence: 84%

Section: Purposementioning

confidence: 99%

Adjuvant pulse-dose-rate brachytherapy for oral cavity and oropharynx carcinoma: Outcome and toxicity assessment of 66 patients

Renard,

Demogeot,

Bruand

et al. 2024

jcb

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“…It has also been postulated that pulsing every second or third hour would be equivalent [12]. Long term clinical outcome data with PDR 24 pulses per day and 12 pulses per day are now available [13][14][15][16]. In contrast, when moving from LDR to HDR the total treatment dose has to be reduced depending on the dose per fraction.…”

Section: General Aspects Of Treatment Planning: Dose and Fractionationmentioning

confidence: 99%

GEC-ESTRO ACROP recommendations for head & neck brachytherapy in squamous cell carcinomas: 1st update – Improvement by cross sectional imaging based treatment planning and stepping source technology

Kovács

Martı́nez-Monge

Budrukkar

et al. 2017

Radiotherapy and Oncology

124

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The Head and Neck Working Group of the GEC-ESTRO (Groupe Européen de Curiethérapie - European Society for Therapeutic Radiology and Oncology) published in 2009 the consensus recommendations for low-dose rate, pulsed-dose rate and high-dose rate brachytherapy in head & neck cancers. The use of brachytherapy in combination with external beam radiotherapy and/or surgery was also covered as well as the use of brachytherapy in previously irradiated patients. Given the developments in the field, these recommendations needed to be updated to reflect up-to-date knowledge. The present update does not repeat basic knowledge which was published in the first recommendation but covers in a general part developments in (1) dose and fractionation, (2) aspects of treatment selection for brachytherapy alone versus combined BT+EBRT and (3) quality assurance issues. Detailed expert committee opinion intends to help the clinical practice in lip-, oral cavity-, oropharynx-, nasopharynx-, and superficial cancers. Different aspects of adjuvant treatment techniques and their results are discussed, as well the possibilities of salvage brachytherapy applications.

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“…Nowadays, brachytherapy is not often used to treat oropharyngeal cancers, because newer external radiation approaches, such as IMRT +/– chemotherapy appear to be very effective. However, analysis of large series have provided data indicating that the use of modalities such as LDR brachytherapy should be optimized in treating these tumors [ 55 – 58 ]. Early studies showed the feasibility of HDR/PDR compared to LDR in oropharyngeal carcinoma treatments [ 59 – 63 ].…”

Section: Oropharynx Cancermentioning

confidence: 99%

Modern head and neck brachytherapy: from radium towards intensity modulated interventional brachytherapy

Kovács¹

2014

jcb

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Intensity modulated brachytherapy (IMBT) is a modern development of classical interventional radiation therapy (brachytherapy), which allows the application of a high radiation dose sparing severe adverse events, thereby further improving the treatment outcome. Classical indications in head and neck (H&N) cancers are the face, the oral cavity, the naso- and oropharynx, the paranasal sinuses including base of skull, incomplete resections on important structures, and palliation. The application type can be curative, adjuvant or perioperative, as a boost to external beam radiation as well as without external beam radiation and with palliative intention. Due to the frequently used perioperative application method (intraoperative implantation of inactive applicators and postoperative performance of radiation), close interdisciplinary cooperation between surgical specialists (ENT-, dento-maxillary-facial-, neuro- and orbital surgeons), as well interventional radiotherapy (brachytherapy) experts are obligatory. Published results encourage the integration of IMBT into H&N therapy, thereby improving the prognosis and quality of life of patients.

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A case–control study of patients with squamous cell carcinoma of the oral cavity and oropharynx treated with pulsed-dose-rate brachytherapy

Cited by 13 publications

References 19 publications

Adjuvant pulse-dose-rate brachytherapy for oral cavity and oropharynx carcinoma: Outcome and toxicity assessment of 66 patients

Adjuvant pulse-dose-rate brachytherapy for oral cavity and oropharynx carcinoma: Outcome and toxicity assessment of 66 patients

GEC-ESTRO ACROP recommendations for head & neck brachytherapy in squamous cell carcinomas: 1st update – Improvement by cross sectional imaging based treatment planning and stepping source technology

Modern head and neck brachytherapy: from radium towards intensity modulated interventional brachytherapy

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