Abstract
PURPOSE
Locoregionally recurrent head and neck cancer is a complex clinical scenario that
often requires multimodality treatment. These patients have often previously received
definitive treatment with a combination of surgery, radiation therapy, and systemic
therapy, which can make further management difficult. A second isolated locoregional
failure is rare and clinicians are faced with a challenge to optimize disease control
while minimizing treatment-related toxicity.
METHODS AND MATERIALS
In this report, we present the diagnosis, management, and outcomes of a patient with
an isolated locoregional recurrence who was previously treated with two courses of
radiation. The patient was treated with a second course of reirradiation using interstitial
brachytherapy as well as a discussion regarding patient selection and optimal management
for recurrent head and neck cancer.
RESULTS
Repeat reirradiation using interstitial HDR-brachytherapy with the use of an alloderm
spacer was successfully delivered to the patient for an in-field right neck nodal
recurrence. He received a total EQD2/BED dose of 127.70/153.24 Gy. At 1-year followup,
the patient was without evidence of recurrent disease or new significant side effects.
CONCLUSION
Recurrent head and neck cancer should be managed with a multidisciplinary approach
given the complex clinical scenario. Reirradiation is a commonly used salvage measure
for recurrent head and neck cancer that requires careful planning and patient selection
due to prior treatment-related effects and dose constraints. We reported a case of
a second course of reirradiation using interstitial HDR-brachytherapy for locoregionally
recurrent head and neck cancer and showed no recurrence of disease or worsening long
term side effects at 1 year.
Keywords
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Article info
Publication history
Published online: December 31, 2022
Accepted:
December 8,
2022
Received in revised form:
December 5,
2022
Received:
September 27,
2022
Publication stage
In Press Corrected ProofFootnotes
Disclosure: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. All authors have no conflicts of interest to disclose.
Identification
Copyright
© 2022 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
