High-dose-rate interstitial brachytherapy for oropharyngeal carcinoma: results of 83 lesions in 82 patients

Institutional Experience of Interstitial Brachytherapy for Head and Neck Cancer with a Comparison of High- and Low Dose Rate Practice

“…Early detection and treatment of disease failure improves the overall disease control rates. The various HDR-IBT series report incidence of 0-29% and 0-8% for soft-tissue-and osteo-necrosis, respectively (Inoue et al, 2001;Kakimoto et al, 2003;Yamazaki et al, 2003;Nose et al, 2004;Guinot et al, 2010;Ghadjar et al, 2012).…”

“…Most experience with interstitial brachytherapy (IBT) for early stage HNC has been reported using the LDR technique (Mazeron et al, 2002). There have been recent reports of HDR brachytherapy employed as a therapeutic modality for HNC (Glatzel et al, 2002;Nose et al, 2004;Guinot et al, 2010;Bartochowska et al, 2012). However, there is considerable variation in the published series with respect to the HDR dose and fractionation schedules.…”

Late Effects of Post-High-Dose-Rate Brachytherapy for Oropharyngeal Carcinoma: Are They Severer than Post-Low-Dose-Rate?

“…In our institutes (Osaka Medical Center [OMC] and Osaka University Hospital [OUH]), more than 80 oropharyngeal carcinoma patients have been treated by HDR. Treatment results were equivalent to the LDR series with local control of 82% and ulceration of 29% for 82 patients [10]. Since there is a concern of severer late normal tissue effects by HDR, late sequelae were meticulously evaluated.…”

“…The standard schedule was 18-36 Gy (median 21)/3-6 fractions/1-3 days HDR following median 46 Gy/ 23 fractions/4.5 weeks external radiotherapy (45-46 Gy, 22 patients) with a 2-3 weeks gap. For HDR cohort, anterior pillar and glossotonsillar sulcus cancers were treated with monotherapy according to the principle described elsewhere [10]. Seven patients were accordingly treated with 48-54 Gy (median 48)/8-9 fractions/4 days HDR alone.…”

“…Seven patients were accordingly treated with 48-54 Gy (median 48)/8-9 fractions/4 days HDR alone. Brachytherapy dose was decided based on initial tumor burden and residual burden after external radiotherapy from the HDR experience in Osaka [5,10,19]. HDR brachytherapy was delivered twice a day with 6 h and 18 h interval between morning and afternoon sessions and afternoon and next morning sessions, respectively.…”