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High-dose-rate brachytherapy plus neck dissection for nodal disease

Authors

  • Jonathan J. Beitler MD, MBA,

    Corresponding author
    1. Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10471
    2. Department of Otolaryngology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
    • Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10471
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  • Madhur Garg MD,

    1. Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10471
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  • Randall P. Owen MD, MS,

    1. Department of General Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
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  • Catherine Sarta RN,

    1. Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10471
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  • Richard V. Smith MD,

    1. Department of Otolaryngology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
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  • Ravindra Yaparpalvi MS

    1. Department of Radiation Oncology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York 10471
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Errata

This article is corrected by:

  1. Errata: Erratum Volume 31, Issue 3, 427, Article first published online: 20 January 2009

  • This article is presented at the 89th Annual Meeting of the American Radium Society, Amsterdam.

Abstract

Background

Regional control for advanced nodal disease has been only marginally affected by concurrent chemoradiation, hyperfractionation, concomitant boost, or accelerated external radiation.

Methods

Twenty-five necks in 24 patients received brachytherapy treatment (20 Gy in 10 twice-daily fractions) in addition to external radiation, neck dissection ± chemotherapy. Indications for brachytherapy included initial treatment of bulky disease (n = 12), recurrence of neck disease in a previously treated patient with at least a 3-month disease-free interval (n = 6), persistent disease after a curative efforts (n = 4), inadequate external radiation (ie, <40 Gy) due to either intolerance or noncompliance (n = 3).

Results

Overall actuarial regional control was 67% at 2 years. Regional control for those receiving brachytherapy as part of their initial treatment was 82% despite a mean nodal diameter of 8.7 cm (range, 5–15 cm). The 2-year actuarial regional control was 56% for the patients with a disease-free interval of at least 3 years.

Conclusion

High-dose-rate brachytherapy produced excellent regional control. © 2008 Wiley Periodicals, Inc. Head Neck, 2008

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