David Leffers (Lübeck), Justina Paul (Lübeck), Tamer Soror (Lübeck), Dirk Rades (Lübeck), Karl-Ludwig Bruchhage (Lübeck), Anke Leichtle (Lübeck)
Introduction: Local recurrence of head and neck cancer is challenging due to the limitations of primary treatment. Surgery is associated with an increased postoperative complication rate and radiotherapy with increased toxicity. In such cases, as a precise radiation technique, interstitial brachytherapy can represent an effective salvage therapy while sparing vital organs. Here, we present an interdisciplinary curative therapy approach consisting of surgical therapy with interstitial brachytherapy for locoregionally recurrent head and neck cancer.
Methods: Retrospective analysis of a group of 60 patients with locoregional recurrence of head and neck cancer who were treated with surgical therapy and interstitial brachytherapy in the Department of Otorhinolaryngology at the UKSH Campus Lübeck. The primary endpoints of the analysis were recurrence-free survival, overall survival determined using the Kaplan-Meier method and treatment-related side effects classified according to CTCAE.
Results: Our cohort predominantly recorded locoregional recurrent head and neck carcinomas (68.3%), all of which had previously been treated with surgical therapy at the time of initial diagnosis. The median dose of the brachytherapy used was 30 Gy and a locoregional recurrence was recorded after a median of 28.9 months. The 5-year recurrence-free survival and overall survival were 37.3% and 16.6%, respectively. We recorded treatment-related side effects ≥ CTCAE 3 in 35% of patients, with the most common side effects being acute pain, dysphagia and dry mouth.
Conclusion: The combination of surgical treatment and interstitial brachytherapy offers a curative treatment option for locoregionally recurrent head and neck cancer with an acceptable toxicity profile.
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