Head and neck cancer reirradiation with interstitial high-dose-rate brachy therapy

Background: As high-dose-rate (HDR) brachytherapy can preferentially spare normal anatomic structures surrounding the radiation target, we report on our experience using this technique in head and neck cancer reirradiation. Methods: Twenty patients received HDR brachytherapy reirradiation with curative or palliative intent from 2010-2015. Clinical and toxicity outcomes were recorded. Actuarial outcomes were calculated using Kaplan-Meier analysis. Results: For curative treatment, actuarial 2-year rates of local control and overall survival (OS) were 73% and 56%, respectively. Palliatively, a 6-month local control rate of 65% was seen. Age > 70 years was associated with poorer OS (P 5.042). Prior salvage resection showed a trend toward improved local control and OS (P 5.069 and P 5.063, respectively). Thirty-three percent had grade 3 to 4 late toxicities. Conclusion: Curative-intent HDR brachytherapy reirradiation can provide excellent local control and encouraging OS. Given the late toxicity rates, patient selection is essential, with particular utility for younger patients or those treated with salvage resection.