AIM: Due to the limited therapeutic options, the management of previously pre-treated recurrent head and neck carcinomas remains a challenging problem. The use of hyper-fractionated-accelerated interstitial high-dose-rate brachytherapy (HDR-BT) might be able to improve safety and survival after surgical resection. MATERIAL AND METHODS: From 2000 to 2006, 13 patients with pre-treated, recurrent head and neck cancer (oral, maxillary sinus, lips) were treated in a curative approach by resection the recurrent tumour and HDR-BT. The concept included coverage of the surgical defect and sealing of the brachytherapy applicators with free microvascular or myocutaneous flaps. Conventional radiotherapy and chemotherapy were added as required. The patient group was re-examined with respect to survival and outcome. Additionally 5 patients, who received this combination therapy for primary carcinomas were included in this report observation in order to evaluate the rate of complications and adverse effects. RESULTS: Kaplan-Meier-curves revealed a 2-year overall survival of 65.3%. The mean survival for recurrent carcinomas was 22.8 months. Patients treated for primary carcinoma had a mean survival of 34.5 months. Four out of five (80%) patients with primary head and neck cancer were alive and without evidence of disease 2 years after treatment. The acute and chronic adverse side effects were manageable. There were no relevant complications concerning tissue transfer. CONCLUSIONS: Surgical resection combined with HDR-BT can lead to long-lasting remissions. A simultaneous microvascular defect reconstruction provides tissue cover for brachytherapy.
AIM: Due to the limited therapeutic options, the management of previously pre-treated recurrent head and neck carcinomas remains a challenging problem. The use of hyper-fractionated-accelerated interstitial high-dose-rate brachytherapy (HDR-BT) might be able to improve safety and survival after surgical resection. MATERIAL AND METHODS: From 2000 to 2006, 13 patients with pre-treated, recurrent head and neck cancer (oral, maxillary sinus, lips) were treated in a curative approach by resection the recurrent tumour and HDR-BT. The concept included coverage of the surgical defect and sealing of the brachytherapy applicators with free microvascular or myocutaneous flaps. Conventional radiotherapy and chemotherapy were added as required. The patient group was re-examined with respect to survival and outcome. Additionally 5 patients, who received this combination therapy for primary carcinomas were included in this report observation in order to evaluate the rate of complications and adverse effects. RESULTS: Kaplan-Meier-curves revealed a 2-year overall survival of 65.3%. The mean survival for recurrent carcinomas was 22.8 months. Patients treated for primary carcinoma had a mean survival of 34.5 months. Four out of five (80%) patients with primary head and neck cancer were alive and without evidence of disease 2 years after treatment. The acute and chronic adverse side effects were manageable. There were no relevant complications concerning tissue transfer. CONCLUSIONS: Surgical resection combined with HDR-BT can lead to long-lasting remissions. A simultaneous microvascular defect reconstruction provides tissue cover for brachytherapy.
Authors: Peter W Henderson; David I Kutler; Bhupesh Parashar; David M Otterburn; Marc A Cohen; Jason A Spector Journal: J Contemp Brachytherapy Date: 2016-08-29
Authors: Julianna Rodin; Voichita Bar-Ad; David Cognetti; Joseph Curry; Jennifer Johnson; Chad Zender; Laura Doyle; David Kutler; Benjamin Leiby; William Keane; Adam Luginbuhl Journal: J Contemp Brachytherapy Date: 2018-10-31
Authors: Michael Kharouta; Chad Zender; Tarun Podder; Rod Rezaee; Pierre Lavertu; Nicole Fowler; Jason Thuener; Shawn Li; Kate Clancy; Zhengzheng Xu; Min Yao Journal: Front Oncol Date: 2021-03-18 Impact factor: 6.244
Authors: Adam Luginbuhl; Alyssa Calder; David Kutler; Chad Zender; Trisha Wise-Draper; Jena Patel; Michael Cheng; Vidhya Karivedu; Tingting Zhan; Bhupesh Parashar; Shuchi Gulati; Min Yao; Pierre Lavertu; Vinita Takiar; Alice Tang; Jennifer Johnson; William Keane; Joseph Curry; David Cognetti; Voichita Bar-Ad Journal: Front Oncol Date: 2021-11-26 Impact factor: 6.244
Authors: V Rudzianskas; A Inciura; E Juozaityte; M Rudzianskiene; R Kubilius; S Vaitkus; M Kaseta; D Adliene Journal: Acta Otorhinolaryngol Ital Date: 2012-10 Impact factor: 2.124