Endoscopy-guided brachytherapy for sinonasal and nasopharyngeal recurrences

Cesium-131 Brachytherapy Seeds for the Treatment of Sinonasal Carcinosarcoma: A Case Report and Literature Review

“…Teudt et al, recently described the outcomes of 35 patients with advanced stage sinonasal tract tumors treated with perioperative image-adapted brachytherapy with or without EBRT and chemotherapy and reported a 72% survival rate at 3 years [32]. Their study and others [20,[33][34][35][36] support the use of BRT to achieve local and regional control, to improve survival rates and to limit toxicity in patients with recurrent or advanced stage malignances of the nasopharynx and paranasal sinuses. Local control rates for nasopharyngeal carcinoma treated with surgery and intracavitary Ir-192 brachytherapy have been found to be similar to those of wide-field irradiation with lower complication rates [37].…”

“…Additionally, resection of skull base tumors is also often complicated by proximity or extension into critical structures resulting in suboptimal outcomes [13,14]. Cesium-131 (Cs-131) Brachytherapy (BRT) is an effective and highly conformal contemporary technique for administering further radiation in a previously irradiated field while limiting toxicity in the treatment of head and neck cancer [15][16][17][18][19][20].…”

HDR interventional radiotherapy (brachytherapy) in the treatment of primary and recurrent head and neck malignancies

“…However, even if it has become clear that brachytherapy may also be used in recurrences, especially in already irradiated fields, its specific value in many clinical situations and in particular in the tricky post‐EB recurrent setting is not yet fully exploited. Our previous studies and the survival figures for the recurrences in the present study (eg, 52% 3‐year, 28% 5‐year DSS; see Figure ) demonstrate a certain rate of long‐term survivors and even of cure in clinical situations often considered inoperable, as post‐EB recurrences, with very low toxicity deriving from the reirradiation . In particular, groups I, II, and III discussed below are mostly made up of recurrences for which IRT offers specific advantages according to the disease site and the clinical situations.…”

“…Plastic tubes were always placed in the operating room in the presence of the surgeons and radiation oncologists under general anesthesia in all except four cases (three inferior lips and a cheek) in which implants were placed under local anesthesia, because of anesthesiology concerns. Flexible Implant 6F Tubes were inserted, spaced 0.8‐1.2 cm apart, using guide channels that were previously placed with a needle and fixed by buttons sutured to the skin and other technical tricks when needed, as previously described . The exact configuration and number of catheters were always tailored to the extent, depth, and shape of the target volume.…”

Image-guided interstitial high-dose-rate brachytherapy in the treatment of inoperable recurrent head and neck malignancies: An effective option of reirradiation

“…4 When reirradiation is the only remaining salvage option, brachytherapy has demonstrated effectiveness in the management of recurrent ENT tumors within previously irradiated volumes. [18][19][20][21]46,47 Bearing in mind the predominantly palliative intention of these approaches, higher grade toxicity rates are of particular relevance, more so as a balance that must be achieved between the probability of local control and the probability of toxic complications. Notwithstanding this, the rationale for reirradiation by means of brachytherapy cannot be called into question considering that it offers radiobiological and technical advantages.…”