Brachytherapy in Head and Neck Cancers: “Are We Doing It or Are We Done with It”

Abstract

We performed an e-Survey and reviewed the literature on the prevalence of use of brachytherapy in head and neck cancers in order to understand the patterns of care and probable application of this modality. A five-point questionnaire was prepared and sent to 300 oncologists through a web-based survey engine. This was done in preparation for my lecture on "Ongoing Research and Potential Research Avenues" in IBSCON held in Chennai in August 2016. SPSS software was used for the statistical analysis. Of a total of 300 emails that were sent out for the survey, 120 replies were received, which is 40%. Among the results of various questions, (i) 65% of the oncologists felt that there were > 300 ongoing studies in brachytherapy and out of them only 10-20 were on head and neck brachytherapy; (ii) 58% of the responders felt that external beam radiotherapy (EBRT) advances followed by lack of training and experience are the reasons for declining role of brachytherapy; (iii) among the responders, numbers of head and neck brachytherapy performed stand third after gynecological and breast brachytherapy. This survey shows that brachytherapy in head and neck cancers is an essential tool, but seldom practiced. If no path-breaking event happens, we may be dealing with it as a dying art.

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

“…The most evident advantage of IRT compared to EBRT in re-irradiation is represented by the virtual absence of severe toxicities. However, IRT remains widely underexploited in daily clinical practice, even if it is probably the safest re-irradiation modality 5 , 31 . This is also because IRT is a multidisciplinary tool at the intersection between surgery and radiotherapy, and close cooperation between surgeons and radiation oncologists during every phase is mandatory, from the recommendation of treatment and implantation in the operating theatre, to the prescription and dose painting within the radiation oncologist unit.…”

Interdisciplinary and Regional Cooperation Towards Head and Neck Cancer Interventional Radiotherapy (Brachytherapy) Implementation in Southeast Asia

“…Other terms came into use, including curie therapy, highlighting the role of The Curies in the discovery and development of the clinical use of radioactivity, and plesiotherapy (plesio-, near) to refer specifically to the application to external body surfaces or skin. [6,7] The newer term interventional radiotherapy (IRT) mainly highlights the use of cross-sectional imaging, volume-based dosimetry and an increasingly interdisciplinary approach to implantation [8,9] that is associated with more modern techniques and recent publications.…”