High-dose-rate brachytherapy in the treatment of recurrent and XXXX .

@entity1 @entity135 @entity137 @entity41 @entity5 @entity751
OBJECTIVES/HYPOTHESIS: Interstitial and endocavitary brachytherapy are well-accepted kinds of radiotherapy that are commonly used in recurrent @entity135 . Most reports about brachytherapy in the successful treatment of @entity135 used low-dose-rate brachytherapy. There are only a few reports about high-dose-rate brachytherapy (HDRBT) in @entity135 @entity1 . METHODS: After 10 years of experience with HDRBT with Ir 192, we have analyzed the results regarding response rates, survival time, and side effects. Between 1991 and 2000, 90 consecutive @entity1 (68 @entity1 , 22 @entity1 ) were treated with interstitial (68 @entity1 ) or intracavitary (22 @entity1 ) HDRBT in the head and neck area. @entity5 locations were as follows: oropharynx (n = 26), tongue/floor of mouth (n = 22), nasopharynx (n = 10), nose/paranasal sinuses (n = 9), salivary glands (n = 5), hypopharynx (n = 5), @entity751 (n = 5), and others (n = 8). High-dose-rate brachytherapy was administered in 51 @entity1 with recurrent disease and in 32 @entity1 with @entity41 after primary radiochemotherapy. Seven @entity1 were given exclusive HDRBT in a primary palliative situation. The single dose per fraction ranged from 1.5 to 7.5 Gy (median value, 5 Gy), and the total HDRBT dose ranged from 4.0 to 42.0 Gy (median value, 17.5 Gy). RESULTS: The overall remission rate was 81% with a 46% rate of complete remissions. We observed no change in or progression of @entity5 in 17 cases (19%). The rate of complete remissions (and median overall survival time) was different in the three therapy groups: in case of recurrent disease, 28% (6 mo); in case of @entity41 , 84% (25 mo); and in primary palliative brachytherapy, 0% (1 mo). Late @entity137 III and IV (radiation treatment oncology group score) occurred in 6 of 90 (6.7%) @entity1 . CONCLUSIONS: High-dose-rate brachytherapy proved to be an effective treatment modality in locoregional recurrent @entity135 . In cases with persistent or @entity41 after primary radiochemotherapy a local boost with brachytherapy can improve the chance of cure of @entity5 disease.
