Salvage brachytherapy of posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area

Treatment of Oral Cavity and Oropharyngeal Cancer

“…Some authors recorded severe side effects ranging from 27% [59,74] to 50-60% [16,20,37,54,77], among them a necrosis rate of up to 15% [54] and side effects grade 4 in up to 7%. Our results [89] regarding the rate of side effects (soft-tissue necrosis 4.6% and, in particular, osteoradionecrosis 0%) are quite comparable with those of Peiffert et al and Pommier et al [66,73]. In our opinion, the low complication rates in our patients are due to the PDR brachytherapy, a method, which unites the biological advantages of LDR brachytherapy with the technological advantages of HDR afterloading.…”

“…Nevertheless, local control rates after 2 years mostly reached 30-40% only [16,25,49,59,63,65,66,73,74,76,78,87,88,94]. Only Mazeron et al, Peiffert et al,Pommier et al,and Strnad et al [59,66,73,89] reported local control rates up to 80%. In our analysis [89], we achieved a permanent local control in 79% of patients (34/43) and a 4-year local recurrence-free survival of 68% in all patients and 80% in patients treated with curative intent (Figure 2).…”

Treatment of squamous cell carcinoma of the posterior pharyngeal wall: Radiotherapy versus surgery

“…Despite advances in diagnosis and treatment techniques, the treatment outcome of this subsite of head and neck cancer remains relatively poor compared with cancers of other head and neck subsites . Most patients are initially diagnosed with advanced disease (70% of patients with T3–T4 disease in our study) because of the absence of symptoms at an early stage and the richness of submucosal lymphatics in the posterior pharyngeal wall.…”

“…Squamous cell carcinoma (SCC) of the posterior pharyngeal wall is a relatively rare location in pharyngeal SCC, accounting for 12% to 20% of this sublocation . Despite the lack of prospective comparison, radiotherapy (RT) — alone or associated with concomitant chemoradiotherapy (CRT) — and surgery have both been utilized to treat this type of cancer.…”

Re-Treatment After Full-Course Radiotherapy: Is It a Viable Option?

“…Pommier et al (63) report on a small series of 14 patients re-irradiated with low dose-rate brachytherapy between 1982 and 1993 for posterior pharyngeal wall carcinomas. The median re-treatment dose was 55 Gy (39 to 60 Gy).…”