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

Abstract

Background Interventional radiotherapy (brachytherapy; IRT) reemerged in the last decades as a potentially useful tool in head and neck oncology after a set of clear technical improvements were developed. Methods Sixty‐one high dose ratio (HDR) IRT treatments were recommended and performed on 58 patients. We classified the cases into four relatively homogeneous groups based on the clinical needs that led to the recommended IRT. Also, we separately evaluated primary and recurrent cases. Results Disease‐specific survival was significantly different among the four treatment groups. The group with the best prognosis was the cohort treated locally by exclusive interstitial IRT for resectable midface malignancies (2‐year relapse‐free survival = 82%, disease‐specific survival = 89%). Conclusion HDR IRT is a valuable tool in well‐defined clinical situations and, in particular, in recurrences. In midface malignancies, it could become the preferred primary treatment.

Multidisciplinary approach to nose vestibule malignancies: setting new standards

“…Anyway, the absence in the AJCC classification of a specific topography code for nose vestibule malignancies which most often are not discriminated from all the other nasal cavity primaries, as well as the frequent misdiagnosis and misclassification of these lesion as cutaneous neoplasms are likely to produce a relevant underestimation of their incidence. When TNM staging system is concerned, staging criteria for the primary lesion (T) according to AJCC are the same as nasal cavity proper and ethmoid, but anatomical features and peculiar pattern of spread make such criteria clearly inadequate for nose vestibule [1][2][3][4][5][6] . In fact skin invasion through the nasal valve (mostly deep to alar and superficial to lateral nasal cartilage) is very frequent among SCC of the NV, and makes most of them cT4a for AJCC.…”

Treatment tolerability and outcomes in elderly patients with head and neck cancer

“…Although elderly patients have historically been excluded from trials due to practical and ethical considerations, including unique medical demands as well as concerns regarding dosing and adverse events, the current consensus is that the elderly should be enrolled with protective measures in place (eg, more frequent follow‐up) 43,44 . Additionally, this cohort in particular may benefit from the use of emerging and re‐emerging low toxicity therapeutic strategies including brachytherapy 45 and de‐intensified hypofractionation 46 . These treatment strategies have already been found to minimize toxicity and improve tolerability which will be especially useful for this patient population.…”

Not only gustatory sweating and flushing: Signs and symptoms associated to the Frey syndrome and the role of botulinum toxin A therapy

“…The study was conducted with a prospective observational design on patients treated with BoNT‐A for Frey syndrome after superficial parotidectomy for pleomorphic adenoma or Warthin tumor, in the Otorhinolaryngology clinics of the Fondazione Policlinico Universitario A. Gemelli in Rome, from January 2016 to November 2019. Exclusion criteria were history of neurologic disease or diabetes, other parotidectomies or parotidectomies for malignant diseases (often submitted to adjuvant treatments), 33,34 insufficient data collected and age <18 years. A written informed consent was obtained from all patients enrolled in the study.…”