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Salvage brachytherapy and salvage surgery for recurrent oropharyngeal carcinoma following radiotherapy

Published online by Cambridge University Press:  29 June 2007

Carlos A. Regueiro*
Affiliation:
Department of Radiation Oncology, Clínica Puerta de Hierro, San Martin de Porres 4, 28035 Madrid, Spain.
Alejandro de la Torre
Affiliation:
Department of Radiation Oncology, Clínica Puerta de Hierro, San Martin de Porres 4, 28035 Madrid, Spain.
Francisco J. Valcárcel
Affiliation:
Department of Radiation Oncology, Clínica Puerta de Hierro, San Martin de Porres 4, 28035 Madrid, Spain.
Rosa MagallóN
Affiliation:
Department of Radiation Oncology, Clínica Puerta de Hierro, San Martin de Porres 4, 28035 Madrid, Spain.
Gregorio Aragón
Affiliation:
Department of Radiation Oncology, Clínica Puerta de Hierro, San Martin de Porres 4, 28035 Madrid, Spain.
*
Address for correspondence: Carlos A. Regueiro, Ph.D., Department of Radiation Oncology, Clínica Puerta de Hierro, San Martin de Porres 4, 28035 Madrid, Spain.

Abstract

We reviewed 21 patients who underwent salvage treatment after a biopsy of proven locally recurrent carcinoma of the oropharynx. Two of these patients underwent a second salvage treatment after failure of the first. Treatment was performed with Ir192 interstitial implant in 17 cases (13 rT1 and 4 rT2); by surgery in five cases (3 rT1, 1 rT2, 1 rTx), including two patients who had relapsed after salvage treatment with Ir192 implant; and by hyperfractionated external beam irradiation plus concomitant Tegafur chemotherapy in one case (rT3).

The primary tumour was controlled in four of the 17 cases (23 percent) treated with Ir192 implant. Of these four patients, two remained disease-free 42 and 59 months after treatment, one died of nodal metastases eight months after treatment and another of distant metastases 19 months after treatment. Four of the five cases (80 per cent) treated with surgery, including two patients who relapsed after salvage brachytherapy, remained free from local, regional and distant relapse 21, 25, 31 and 56 months after treatment.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1995

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References

American Joint Committee on Cancer (1992). Manual for Staging of Cancer, 4th Edition., J. B. Lippincott Co., Philadelphia, USA.Google Scholar
Fontanesi, J., Hetzler, D., Ross, J. (1989) Effect of dose rate on local control and complications in the reirradiation of head and neck tumors with interstitial iridium-192. International Journal of Radiation, Oncology, Biology and Physics 17: 365369.CrossRefGoogle ScholarPubMed
Foote, R. L., Parsons, J. T., Mendenhall, W. M., Million, R. R., Cassisi, N. J., Stringer, S. P. (1990) Is interstitial implantation essential for successful radiotherapeutic treatment of base of tongue carcinoma? International Journal of Radiation, Oncology, Biology and Physics 18: 12931298.CrossRefGoogle ScholarPubMed
Gehanno, P., Depondt, J., Guedon, C., Kebaili, C., Koka, V. (1993) Primary and salvage surgery for cancer of the tonsillar region: a retrospective study of 120 patients. Head and Neck – Journal for the Sciences and Specialities of the Head and Neck 15: 185189.CrossRefGoogle ScholarPubMed
Haie, C., Mazeron, J. J., Chassagne, D., Gerbaulet, A., Marandas, P. (1983) Curiethérapie de rattrapage des tumeurs de la base de langue. Á propos de 21 cas traités de 1970 á 1978 á l'lnstitut Gustave-Roussy. Journal Européen de Radiothérapie, Oncologie, Radiophysique et Radiobiologie 4: 139142.Google Scholar
Housset, M., Baillet, F., Delanian, S., Brunei, P., Maulard, C., Michel-Langlet, P., Huart, J., Maylin, C., Boisserie, G. (1991) Split-course interstitial brachytherapy with a source shift: the results of a new iridium implant technique versus single course implants for salvage irradiation of base of tongue cancers in 55 patients. International Journal of Radiation Oncology, Biology and Physics 20: 965971.CrossRefGoogle ScholarPubMed
International Union Against Cancer (UICC) (1992). TNM Classification of Malignant Tumours, 4th Edition., 2nd revision, Springer-Verlag, Berlin.Google Scholar
Langlois, D., Eschwege, F., Kramar, A., Richard, J. M. (1985) Reirradiation of head and neck cancers. Presentation of 35 cases treated at the Gustave-Roussy Institute. Radiotherapy and Oncology 3: 2733.CrossRefGoogle ScholarPubMed
Langlois, D., Hoffstetter, S., Malissard, L., Pernot, M., Taghian, A. (1988) Salvage irradiation of oropharynx and mobile tongue: Iridium-192 brachytherapy in Centre Alexis Vautrin. International Journal of Radiation Oncology, Biology and Physics 14: 849853.CrossRefGoogle Scholar
Levendag, P. C., Meeuwis, C. A., Visser, A. G. (1992) Reirradiation of recurrent head and neck cancers: external and/lor interstitial radiation therapy. Radiotherapy and Oncology 23: 615.CrossRefGoogle Scholar
Mazeron, J. J., Langlois, D., Glaubiger, D., Huart, J.Martin, M., Raynal, M., Calitchi, E., Ganem, G., Faraldi, M., Feuilhade, F., Brun, B., Marin, L., Le Bourgeois, J. P., Baillet, F., Pierquin, B. (1987) Salvage irradiation of oropharyngeal cancers using Iridium-192 wire implants: five-year results of 70 cases. International Journal of Radiation Oncology, Biology and Physics 13: 957962.CrossRefGoogle Scholar
Mendenhall, W. M., Parsons, J. T., Cassisi, N. J., Million, R. R. (1987) Squamous cell carcinoma of the tonsillar fossa treated with radical irradiation. Radiotherapy and Oncology 10: 2330.CrossRefGoogle Scholar
Pacheco-Ojeda, L., Marandas, P., Julieron, M., Lusinchi, A., Mamelle, G., Luboinski, B. (1992) Salvage surgery by composite resection for epidermoid carcinoma of the tonsillar region. Archives of Otolaryngology, Head and Neck Surgery 118: 181184.CrossRefGoogle ScholarPubMed
Puthawala, A. A., Syed, A. M. S., Gates, T. H. (1985) Iridium-192 implants in the treatment of tonsillar region malignancies. Archives of Otolaryngology 111: 812815.CrossRefGoogle ScholarPubMed
Skolyszewski, J., Korzeniowski, S., Reinfuss, M. (1980) The reirradiation of recurrences of head and neck cancer. British Journal of Radiology 53: 462465.CrossRefGoogle ScholarPubMed
Syed, A. M. N., Feder, B. H., George, F. W. III., Neblett, D. (1978) Iridium-192 afterloaded implant in the retreatment of head and – neck cancers. British Journal of Radiology 51: 814820.CrossRefGoogle ScholarPubMed
Viani, L., Dammeijer, P., Jones, A. S., Dalbyj., E. j., E., Stell, P. M. (1991) Recurrence of oropharyngeal carcinoma after radiotherapy. Journal of Laryngology and Otology 105: 2428.CrossRefGoogle ScholarPubMed
Wong, C. S., Ang, K. K., Fletcher, G. H., Thames, H. D., Peters, L. J., Byers, R. M., Oswald, M. J. (1989) Definitive radiotherapy for squamous cell carcinoma of the tonsillar fossa. International Journal of Radiation Oncology, Biology and Physics 16: 657662.CrossRefGoogle ScholarPubMed