Advertisement

Feasibility of collagen matrix tiles with cesium-131 brachytherapy for use in the treatment of head and neck cancer

Published:November 08, 2022DOI:https://doi.org/10.1016/j.brachy.2022.09.160

      ABSTRACT

      BACKGROUND

      Locoregional failure is a unique and challenging problem in head and neck cancer with controversy surrounding the use of re-irradiation in the treatment. We aimed to evaluate the dosimetry and technical parameters in utilizing a collagen matrix with embedded Cesium-131 (Cs-131) radioactive isotope seeds as it relates to dose distribution and dose to carotid artery.

      METHODS AND MATERIALS

      Cadaveric feasibility study randomizing Cs-131 strands alone or Cs-131 with collagen matrix to be placed into neck dissection defects. For the dose computation, physicists employed the TG-43 dosimetry calculation algorithm with a point source assumption to compute the dose. Carotid arteries were contoured in MIM-Symphony software and the carotid artery maximum and mean doses were calculated in accordance with TG-43 specifications. Ease of use of collagen matrix tiles on a 7-point Likert scale and mean radiation dose to the carotid artery.

      RESULTS

      Ease of use score was higher in collagen matrix compared to stranded seeds with a mean score of 6.3 +/- 1.2 compared to 4.5 +/- 0.87. Time of implantation was statistically significantly, p = 0.031, lower in the collagen matrix group (M = 5.17 min, SD = 4.62) compared to stranded seeds (M = 15.83 min, SD = 3.24). Mean radiation dose to the carotid artery was 62.8 Gy +/- 9.46 in the collagen matrix group compared to 108.2 Gy +/- 55.6 in the traditional Cs-131 seeds group.

      CONCLUSIONS

      We present a feasibility and concept cadaveric study using a collagen matrix with Cesium-131 demonstrating preliminary evidence to support its ease of use, decreased time to implantation, and decreased dose delivered to the carotid artery.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Brachytherapy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Cohen EE
        • LaMonte SJ
        • Erb NL
        • et al.
        American Cancer Society Head and Neck Cancer Survivorship Care Guideline.
        CA Cancer J Clin. 2016; 66: 203-239
        • Gregoire V
        • Lefebvre JL
        • Licitra L
        • et al.
        Squamous cell carcinoma of the head and neck: EHNS-ESMO-ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up.
        Ann Oncol. 2010; 21 (Suppl): v184-v186
        • Gujral DM
        • Nutting CM.
        Patterns of failure, treatment outcomes and late toxicities of head and neck cancer in the current era of IMRT.
        Oral Oncol. 2018; 86: 225-233
        • Luginbuhl A
        • Calder A
        • Kutler D
        • et al.
        Multi-institutional study validates safety of intraoperative Cesium-131 brachytherapy for treatment of recurrent head and neck cancer.
        Front Oncol. 2021; 11786216
        • Pham A
        • Arora S
        • Wernicke AG
        • et al.
        Cesium-131 brachytherapy in high risk and recurrent head and neck cancers: first report of long-term outcomes.
        J Contemp Brachytherapy. 2015; 7: 445-452
        • Bar-Ad V
        • Hubley E
        • Luginbuhl A
        • et al.
        Single institution implementation of permanent (131)Cs interstitial brachytherapy for previously irradiated patients with resectable recurrent head and neck carcinoma.
        J Contemp Brachytherapy. 2019; 11: 227-234
        • Hubley E
        • Trager M
        • Bar-Ad V
        • et al.
        A nomogram to determine required seed air kerma strength in planar (131)Cesium permanent seed implant brachytherapy.
        J Contemp Brachytherapy. 2019; 11: 91-98
        • Greenwald J
        • Taube S
        • Yondorf MZ
        • et al.
        Placement of (131)Cs permanent brachytherapy seeds in a large combined cavity of two resected brain metastases in one setting: case report and technical note.
        J Contemp Brachytherapy. 2019; 11: 356-360
        • Wernicke AG
        • Yondorf MZ
        • Peng L
        • et al.
        Phase I/II study of resection and intraoperative cesium-131 radioisotope brachytherapy in patients with newly diagnosed brain metastases.
        J Neurosurg. 2014; 121: 338-348
        • Gessler DJ
        • Ferreira C
        • Dusenbery K
        • Chen CC.
        GammaTile((R)): surgically targeted radiation therapy for glioblastomas.
        Future Oncol. 2020; 16: 2445-2455
        • Brachman D
        • Youssef E
        • Dardis C
        • et al.
        Surgically targeted radiation therapy: safety profile of collagen tile brachytherapy in 79 recurrent, previously irradiated intracranial neoplasms on a prospective clinical trial.
        Brachytherapy. 2019; 18: S35-S36
        • Brachman DG
        • Youssef E
        • Dardis CJ
        • et al.
        Resection and permanent intracranial brachytherapy using modular, biocompatible cesium-131 implants: results in 20 recurrent, previously irradiated meningiomas.
        J Neurosurg. 2018; 131: 1819-1828
        • Ferreira C
        • Sterling D
        • Reynolds M
        • et al.
        First clinical implementation of GammaTile permanent brain implants after FDA clearance.
        Brachytherapy. 2021; 20: 673-685
        • Wernicke AG
        • Hirschfeld CB
        • Smith AW
        • et al.
        Clinical outcomes of large brain metastases treated with neurosurgical resection and intraoperative Cesium-131 brachytherapy: results of a prospective trial.
        Int J Radiat Oncol Biol Phys. 2017; 98: 1059-1068
        • Wernicke AG
        • Smith AW
        • Taube S
        • et al.
        Cesium-131 brachytherapy for recurrent brain metastases: durable salvage treatment for previously irradiated metastatic disease.
        J Neurosurg. 2017; 126: 1212-1219
        • Waters JD
        • Rose B
        • Gonda DD
        • et al.
        Immediate post-operative brachytherapy prior to irradiation and temozolomide for newly diagnosed glioblastoma.
        J Neurooncol. 2013; 113: 467-477
        • Bourgier C
        • Coche-Dequeant B
        • Fournier C
        • et al.
        Exclusive low-dose-rate brachytherapy in 279 patients with T2N0 mobile tongue carcinoma.
        Int J Radiat Oncol Biol Phys. 2005; 63: 434-440
        • Kharouta M
        • Zender C
        • Podder T
        • et al.
        Permanent interstitial Cesium-131 brachytherapy in treating high-risk recurrent head and neck cancer: a prospective pilot study.
        Front Oncol. 2021; 11639480
        • Savard C
        • Epps G
        • Ad VB
        • et al.
        Cesium-131 Interstitial brachytherapy for recurrent malignancies of skull base.
        J Neurol Surg Rep. 2019; 80: e23-e26
        • Rodriguez-Lopez JL
        • Patel AK
        • Benoit RM
        • et al.
        Treatment of intermediate-risk prostate cancer with Cs-131: long-term results from a single institution.
        Brachytherapy. 2022; 21: 79-84
        • Yang R
        • Wang J
        • Zhang H.
        Dosimetric study of Cs-131, I-125, and Pd-103 seeds for permanent prostate brachytherapy.
        Cancer Biother Radiopharm. 2009; 24: 701-705
        • Tomaszewski JJ
        • Smaldone MC
        • Makaroun S
        • et al.
        Cesium 131 versus iodine 125 implants for prostate cancer: evaluation of early PSA response.
        Can J Urol. 2010; 17: 5360-5364
        • Nakaji P
        • Smith K
        • Youssef E
        • et al.
        Resection and surgically targeted radiation therapy for the treatment of larger recurrent or newly diagnosed brain metastasis: results from a prospective trial.
        Cureus. 2020; 12: e11570
        • Magill ST
        • Schwartz TH
        • Theodosopoulos PV
        • McDermott MW.
        Brachytherapy for meningiomas.
        Handb Clin Neurol. 2020; 170: 303-307
        • Fan Y
        • Huang MW
        • Zhao YJ
        • et al.
        Radioactive seed migration following parotid gland interstitial brachytherapy.
        Brachytherapy. 2017; 16: 1219-1224