Document Type
Article
Publication Date
11-26-2021
Abstract
Introduction: Surgery is the primary treatment for resectable, non-metastatic recurrent head and neck squamous cell carcinoma (HNSCC). We explore the safety and oncologic benefit of intraoperative Cesium-131 (Cs-131) brachytherapy combined with salvage local and/or regional surgical resection.
Methods and materials: Findings were reported from a single arm multi-institutional prospective phase 1/2 trial involving surgery plus Cs-131 (surgery + Cs-131) treatment. The results of two retrospective cohorts-surgery alone and surgery plus intensity modulated radiation therapy (surgery + ReIMRT)-were also described. Included patients had recurrent HNSCC and radiation history. Safety, tumor re-occurrence, and survival were evaluated.
Results: Forty-nine patients were enrolled in the surgery + Cs-131 prospective study. Grade 1 to 3 adverse events (AEs) occurred in 18 patients (37%), and grade 4 AEs occurred in 2 patients. Postoperative percutaneous endoscopic gastrostomy (PEG) tubes were needed in 10 surgery + Cs-131 patients (20%), and wound and vascular complications were observed in 12 patients (24%). No cases of osteoradionecrosis were reported in the surgery + Cs-131 cohort. We found a 49% 2-year disease-free survival at the site of treatment with a substantial number of patients (31%) developing metastatic disease, which led to a 31% overall survival at 5 years.
Conclusions: Among patients with local/regional recurrent HNSCC status-post radiation, surgery + Cs-131 demonstrated acceptable safety with compelling oncologic outcomes, as compared to historic control cohorts.
Clinical trial registration: ClinicalTrials.gov, identifiers NCT02794675 and NCT02467738.
Recommended Citation
Luginbuhl, Adam J.; Calder, Alyssa; Kutler, David; Zender, Chad; Wise-Draper, Trisha; Patel, Jena; Cheng, Michael; Karivedu, Vidhya; Zhan, Tingting; Parashar, Bhupesh; Gulati, Shuchi; Yao, Min; Lavertu, Pierre; Takiar, Vinita; Tang, Alice; Johnson, Jennifer; Keane, William M.; Curry, Joseph; Cognetti, David; and Bar-Ad, Voichita, "Multi-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer" (2021). Department of Otolaryngology - Head and Neck Surgery Faculty Papers. Paper 60.
https://jdc.jefferson.edu/otofp/60
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
PubMed ID
34900741
Language
English
Comments
This article is the author’s final published version in Frontiers in Oncology, Volume 11, November 2021, Article number 786216.
The published version is available at https://doi.org/10.3389/fonc.2021.786216. Copyright © Luginbuhl et al.