Intraoperative high-dose-rate radiotherapy in the management of locoregionally recurrent head and neck cancer

Head Neck. 2013 Apr;35(4):485-92. doi: 10.1002/hed.23007. Epub 2013 Mar 5.

Abstract

Background: The purpose of this article was to present the Beth Israel Medical Center experience using high-dose-rate intraoperative radiotherapy (HDR-IORT) in the management of recurrent head and neck cancer.

Methods: We conducted a retrospective review of all patients with locally or regionally recurrent head and neck cancer who underwent HDR-IORT at our institution between 2001 and 2010.

Results: Seventy-six patients were identified who underwent treatment to a total of 87 sites after gross-total resection. The 2-year estimate of in-field tumor control was found to be 62%. Median overall survival was 19 months with 42% of the patients surviving at least 2 years. Significantly longer survival was found for patients achieving in-field control versus infield progression (33 months vs 17 months, respectively; p = .01).

Conclusion: HDR-IORT is well tolerated and associated with encouraging in-field disease control. In-field control is associated with improved survival. Further study is warranted to more fully investigate HDR-IORT in the salvage setting.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / radiotherapy*
  • Head and Neck Neoplasms / surgery
  • Humans
  • Intraoperative Period
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / radiotherapy*
  • Prognosis
  • Radiotherapy Dosage
  • Retrospective Studies
  • Survival Analysis
  • Treatment Outcome
  • Young Adult