Cesium-131 brachytherapy in high risk and recurrent head and neck cancers: first report of long-term outcomes

Pham, Anthony; Arora, Shruthi; Wernicke, A. Gabriella; Kutler, David I.; Cohen, Marc A.; Kuhel, William I.; Trichter, Samuel; Nori, Dattatreyudu; Formenti, Silvia C.; Parashar, Bhupesh

doi:10.5114/jcb.2015.56764

Cited by 15 publications

(24 citation statements)

References 51 publications

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“…In contrast, Pham et al . [ 23 ] reported similar or lower rates of acute and chronic toxicity with 131 Cs as compared to studies using 192 Ir and 125 I. Only 2 of 18 patients had grade 3 toxicity and none had grade 4-5 toxicity.…”

Section: Resultsmentioning

confidence: 95%

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A systematic review of treating recurrent head and neck cancer: a reintroduction of brachytherapy with or without surgery

Rodin¹,

Bar‐Ad²,

Cognetti³

et al. 2018

jcb

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PurposeTo review brachytherapy use in recurrent head and neck carcinoma (RHNC) with focus on its efficacy and complication rates.Material and methodsA literature search of PubMed, Ovid, Google Scholar, and Scopus was conducted from 1990 to 2017. Publications describing treatment of RHNC with brachytherapy with or without surgery were included. The focus of this review is on oncologic outcomes and the safety of brachytherapy in the recurrent setting.ResultsThirty studies involving RHNC treatment with brachytherapy were reviewed. Brachytherapy as adjunctive treatment to surgical resection appears to be associated with an improved local regional control and overall survival, when compared with the published rates for re-irradiation utilizing external beam radiotherapy (RT) or brachytherapy alone. Safety data remains variable with different isotopes and dose rates with implantable brachytherapy demonstrating a tolerable side effect profile.ConclusionsAlthough surgery remains a mainstay treatment for RHNC, intraoperative interstitial brachytherapy delivery as adjunctive therapy may improve the treatment outcome and may be associated with fewer complication rates as compared to reirradiation using external beam radiotherapy. Further investigations are required to elucidate the role of brachytherapy for RHNC.

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Section: Resultsmentioning

confidence: 95%

“…Pham et al . [ 23 ] showed that in selected patients, 131 Cs intraoperative seeds with salvage surgery achieved 1-, 2-, and 3-year LC rates of 69%, 62%, and 52%, respectively.…”

Section: Resultsmentioning

confidence: 99%

A systematic review of treating recurrent head and neck cancer: a reintroduction of brachytherapy with or without surgery

Rodin¹,

Bar‐Ad²,

Cognetti³

et al. 2018

jcb

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show abstract

“…In particular, Pham et al . recently showed that 131 Cs LDR treatment in RH&NC led to survival rates comparable to that of EBR, with a reduced rate of radiation-induced toxicity [ 10 ]. Similarly, Kishan et al .…”

Section: Discussionmentioning

confidence: 99%

Neither high-dose nor low-dose brachytherapy increases flap morbidity in salvage treatment of recurrent head and neck cancer

Henderson

Kutler²,

Parashar

et al. 2016

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PurposeWhile brachytherapy is often used concurrently with flap reconstruction following surgical ablation for head and neck cancer, it remains unclear whether it increases morbidity in the particularly high risk subset of patients undergoing salvage treatment for recurrent head and neck cancer (RH&NC).Material and methodsA retrospective chart review was undertaken that evaluated patients with RH&NC who underwent flap coverage after surgical re-resection and concomitant brachytherapy. The primary endpoint was flap viability, and the secondary endpoints were flap and recipient site complications.ResultsIn the 23 subjects included in series, flap viability and skin graft take was 100%. Overall recipient site complication rate was 34.8%, high-dose radiation (HDR) group 50%, and low-dose radiation (LDR) group 29.4%. There was no statistically significant difference between these groups.ConclusionsIn patients who undergo flap reconstruction and immediate postoperative radiotherapy following salvage procedures for RH&NC, flap coverage of defects in combination with brachytherapy remains a safe and effective means of providing stable soft tissue coverage.

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“…Cesium-131 is a novel radioisotope that has only recently been reported in the treatment of recurrent head and neck cancers as an effective adjuvant therapeutic modality to surgical resection with low rates of acute toxicity [19]. We hypothesize that temporary Cs-131 seed placement may hold significant therapeutic potential for the treatment of radiation-induced skull base tumors in the face of limited treatment options.…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, resection of skull base tumors is also often complicated by proximity or extension into critical structures resulting in suboptimal outcomes [13,14]. Cesium-131 (Cs-131) Brachytherapy (BRT) is an effective and highly conformal contemporary technique for administering further radiation in a previously irradiated field while limiting toxicity in the treatment of head and neck cancer [15][16][17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Cesium-131 Brachytherapy Seeds for the Treatment of Sinonasal Carcinosarcoma: A Case Report and Literature Review

Kutler¹

2017

OHNS

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A 70-year old male with poor cognitive function presented to an outside hospital in November 2010 with recurrent left-sided epistaxis. This patient had a history significant for anaplastic oligoastrocytoma Patel KR, et al., J Otolaryng Head Neck Surg 2017, 3: Radiation-induced tumors of the skull base pose a significant treatment challenge. Temporary Brachytherapy (BRT) with Cesium-131(Cs-131) seeds is a novel therapeutic technique that holds significant potential for the achievement of local tumor control in patients with limited therapeutic options. MethodsWe report a 70 year-old patient with a history of anaplastic oligoastrocytoma who presented with recurrent left-sided epistaxis. Imaging and biopsy results revealed a high-grade carcinosarcoma of the paranasal sinuses and skull base. The Sinonasal Carcinosarcoma (SN-CS) was resected and the residual micro tumor was treated with Cs-131 BRT seeds attached to a vicryl mesh, which was removed 6 weeks later. ResultsFollow-up examination demonstrated no evidence of recurrence or metastasis for 9 months and the patient had an overall survival of 15 months after treatment with Cs-131 BRT. ConclusionTemporary BRT with Cs-131 seeds may play a pivotal role in achieving local tumor control and palliation in patients with aggressive skull base tumors who are precluded from receiving more extensive forms of radiotherapy.

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Cesium-131 brachytherapy in high risk and recurrent head and neck cancers: first report of long-term outcomes

Cited by 15 publications

References 51 publications

A systematic review of treating recurrent head and neck cancer: a reintroduction of brachytherapy with or without surgery

A systematic review of treating recurrent head and neck cancer: a reintroduction of brachytherapy with or without surgery

Neither high-dose nor low-dose brachytherapy increases flap morbidity in salvage treatment of recurrent head and neck cancer

Cesium-131 Brachytherapy Seeds for the Treatment of Sinonasal Carcinosarcoma: A Case Report and Literature Review

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