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High‐dose‐rate brachytherapy plus neck dissection for nodal disease
Author(s) -
Beitler Jonathan J.,
Garg Madhur,
Owen Randall P.,
Sarta Catherine,
Smith Richard V.,
Yaparpalvi Ravindra
Publication year - 2008
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.20799
Subject(s) - medicine , brachytherapy , concomitant , neck dissection , radiation therapy , dissection (medical) , surgery , hyperfractionation , head and neck , radiology , nuclear medicine , dose fractionation , cancer
Background Regional control for advanced nodal disease has been only marginally affected by concurrent chemoradiation, hyperfractionation, concomitant boost, or accelerated external radiation. Methods Twenty‐five necks in 24 patients received brachytherapy treatment (20 Gy in 10 twice‐daily fractions) in addition to external radiation, neck dissection ± chemotherapy. Indications for brachytherapy included initial treatment of bulky disease ( n = 12), recurrence of neck disease in a previously treated patient with at least a 3‐month disease‐free interval ( n = 6), persistent disease after a curative efforts ( n = 4), inadequate external radiation (ie, <40 Gy) due to either intolerance or noncompliance ( n = 3). Results Overall actuarial regional control was 67% at 2 years. Regional control for those receiving brachytherapy as part of their initial treatment was 82% despite a mean nodal diameter of 8.7 cm (range, 5–15 cm). The 2‐year actuarial regional control was 56% for the patients with a disease‐free interval of at least 3 years. Conclusion High‐dose‐rate brachytherapy produced excellent regional control. © 2008 Wiley Periodicals, Inc. Head Neck, 2008