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Local Control, Survival, and Toxicity Outcomes with High-Dose-Rate Peri-Operative Interventional Radiotherapy (Brachytherapy) in Head and Neck Cancers: A Systematic Review.
Bacorro, Warren; Fionda, Bruno; Soror, Tamer; Bussu, Francesco; Kovács, György; Tagliaferri, Luca.
Afiliación
  • Bacorro W; Department of Clinical Epidemiology, Faculty of Medicine and Surgery, University of Santo Tomas, 1008 Manila, Philippines.
  • Fionda B; Department of Radiation Oncology, Benavides Cancer Institute, University of Santo Tomas Hospital, 1008 Manila, Philippines.
  • Soror T; Department of Radiation Oncology, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy.
  • Bussu F; Department of Radiation Oncology, University of Lübeck/UKSH-CL, 23562 Lübeck, Germany.
  • Kovács G; Department of Medicine Surgery and Pharmacy, Sassari University, 07100 Sassari, Italy.
  • Tagliaferri L; Otolaryngology Division, Azienda Ospedaliera Universitaria di Sassari, 07100 Sassari, Italy.
J Pers Med ; 14(8)2024 Aug 11.
Article en En | MEDLINE | ID: mdl-39202044
ABSTRACT
Background. Peri-operative interventional radiotherapy (POIRT) entails tumor resection, catheter implantation in the same surgery, and irradiation within the peri-operative period. It allows for maximal tumor burden reduction, better tumor bed identification, more flexible implant geometry, highly conformal irradiation, and treatment delay minimization. We reviewed the published local control, survival, toxicity, and quality of life (QOL) outcomes with POIRT for head and neck cancers (HNCs) in primary and re-irradiation settings. Materials and Methods. A systematic search of PubMed, Scopus, Science Direct, and other databases, supplemented by bibliography scanning and hand-searching, yielded 107 titles. Fifteen unique articles were eligible, five of which were merged with more updated studies. Of the ten remaining studies, four reported on primary POIRT, and seven reported on reirradiation POIRT. Given data heterogeneity, only qualitative synthesis was performed. Results. Primary POIRT in early tongue cancer results in 6-year recurrence-free (RFS) and overall survival (OS) of 92% for both; in advanced HNCs, the 9-year RFS and OS rates are 52% and 55%. Grade 1-2 toxicity is very common; grade 3-4 toxicity is rare, but grade 5 toxicity has been reported. POIRT re-irradiation for recurrent HNCs results in 5y RFS and OS rates of 37-55% and 17-50%; better outcomes are achieved with gross total resection (GTR). QOL data are lacking. Conclusions. Primary POIRT is safe and effective in early tongue cancers; its use in other HNC sites, especially in advanced disease, requires careful consideration. Re-irradiation POIRT is most effective and safe when combined with GTR; toxicity is significant and may be limited by careful case selection, implant planning and execution, use of smaller fraction sizes, and adherence to homogeneity constraints. Study Registration Number. PROSPERO Registry Number CRD42024548294.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pers Med Año: 2024 Tipo del documento: Article País de afiliación: Filipinas Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Pers Med Año: 2024 Tipo del documento: Article País de afiliación: Filipinas Pais de publicación: Suiza