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Endoscopic ultrasound-guided brachytherapy of head and neck tumours. A new procedure for controlled application

Published online by Cambridge University Press:  29 June 2007

Wolfgang Maier ,
Karl Henne ,
Annette Krebs  and
Jörg Schipper
Wolfgang Maier*
Affiliation:
Department of Oto-Rhino-LaryngologyUniversität Freiburg, Germany.
Karl Henne
Affiliation:
Department of RadiotherapyUniversität Freiburg, Germany.
Annette Krebs
Affiliation:
Department of Oto-Rhino-LaryngologyUniversität Freiburg, Germany.
Jörg Schipper
Affiliation:
Department of Oto-Rhino-LaryngologyUniversität Freiburg, Germany.
*
Address for correspondence: Wolfgang Maier, M.D., Department of Oto-Rhino-Laryngology, (Universitäts-Hals-Nasen-Ohren-Klinik), Killianstrasse 5, D-79106 Freiburg, Germany. Fax: 49-761-270-4189
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Abstract

Brachytherapy is an established procedure in primary and in recurrent cancer. We perform afterloading brachytherapy during general anaesthesia. The target organ is punctured with hollow needles which are loaded with 192iridium via remote control. The depth and number of needles depend on tumour extension. In the interdisciplinary approach of our departments, this method has been improved and supplied by B-scan ultrasound control. Needles are positioned under continuous ultrasonographic guidance, and adjacent structures (e.g. the carotid artery) are localized ultrasonographically. Thus violation of the large vessels is avoided and the exact position of the needles within the tumour is improved.

In this paper, we report results on 22 patients suffering from recurrent carcinoma of the head and neck following surgery and curative radiation, and 17 patients with first onset of cancer. We did not observe any severe complications such as haemorrhage, osteomyelitis, or dyspnoea. The only side-effect was temporary oedema, sometimes associated with a short-term increase of pain. No systemic side-effects occurred.

The method is described and results from both patient groups are reported in detail. We conclude from our data that ultrasonographically-controlled endoscopic brachytherapy is a valuable procedure in locally-advanced primary, and in recurrent head and neck cancer.

Keywords

Head and neck neoplasmsBrachytherapy
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 1 , January 1999 , pp. 41 - 48
Copyright
Copyright © JLO (1984) Limited 1999

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Footnotes

Presented as a poster at the 101st Annual Meeting of the American Academy of Otolaryngology, Head and Neck Surgery, San Francisco, September 7–10, 1997.

References

Buentzel, J., Kuttner, K. (1995) Possible applications of brachytherapy from the viewpoint of the ENT physician. Laryngo-Rhino-Otologie 74: 673–677.Google Scholar
Choo, R., Grimard, L., Esche, B., Crook, J., Genest, P., Odell, P. (1993) Brachytherapy of neck metastases. Journal of Otolaryngology 22: 54–57.Google ScholarPubMed
Close, L. G., Morrish, T. N., Nguyen, P. (1993) Intraoperative versus interstitial radiotherapy: A comparison of morbidity in the head and neck. Laryngoscope 103: 231–246.CrossRefGoogle ScholarPubMed
Delanian, S., Housset, M., Brunel, P., Rozec, C., Moulard, C., Huart, J., Baillet, F. (1992) 192Iridium plesiocurietherapie using silicone elastomer plates for extensive locally recurrent breast cancer following chest wall irradiation. International Journal of Radiation Oncology, Biology, Physics 22: 1099–1104.CrossRefGoogle Scholar
Delclos, M. E., Komaki, R., Morice, R. C., Allen, P. K., Davis, M., Garden, A. (1996) Endobronchial brachytherapy with high-dose-rate remote after loading for recurrent endobronchial lesions. Radiology 201: 279–282.CrossRefGoogle ScholarPubMed
Dutreix, A. (1988) Can we compare systems for interstitial therapy? Radiotherapy and Oncology 55: 122–125.Google Scholar
Fein, D. A., Mendenhall, W. M., Parsons, J. T., McCarty, P. J., Stringer, S. P., Million, R. R., Cassisi, N. J. (1994) Carcinoma of the oral tongue: A comparison of results and complications of treatment with radiotherapy and/or surgery. Head and Neck 16: 358–365.CrossRefGoogle ScholarPubMed
Fietkau, R. (1992) Brachytherapy for head and neck tumors. Brachytherapy Journal (Suppl 3): 3–14.Google Scholar
Fontanesi, J., Hetzler, D., Ross, J. (1989) Effect of dose rate on local tumor control and complications in the reirradiation of head and neck tumors with interstitial 192Iridium. International Journal of Radiation Oncology, Biology, Physics 17: 365–369.CrossRefGoogle Scholar
Friedrich, R. E., Krull, A., Hellner, D., Schwarz, R., Heyer, D., Plambeck, K., Schmelzle, R. (1995) Interstitial high-dose rate brachytherapy with 192Iridium in patients with oral squamous cell carcinoma. Journal of Cranial-Maxillo-Facial Surgery 23: 238–242.CrossRefGoogle Scholar
Gerbaulet, A., Haie-Meder, C., Marsiglia, H., Kumar, U., Lusinchi, A., Habrand, J. L. (1992) The role of brachytherapy in treatment of head and neck cancer: Institut Gustave Roussy experience with 1140 patients. In International brachytherapy – Programme and Abstracts of the 7th International Brachytherapy Working Conference. Baltimore/Washington, 09 1992. Nucleotron Int., Veenendaal, NL, pp 49–66.Google Scholar
Habrand, J. L., Gerbaulet, A., Pejoviv, M. H., Contesso, G., Durand, S., Haie, C., Genin, J. (1991) Twenty years experience of interstitial iridium brachytherapy in the management of soft tissue sarcomas. International Journal of Radiation Oncology, Biology, Physics 20: 405–411.CrossRefGoogle ScholarPubMed
Hentschke, U. K., Hilaris, B., Mahan, G. D. (1963) Afterloading in interstitial and intracavity radiation therapy. American Journal of Roentgenology 90: 386–395.Google Scholar
Hoffstetter, S., Malissard, L., Pernot, M., Luporsi, E., Peiffert, D., Lapeyre, M. (1996) Retrospective study of 136 cases of epidermoid carcinoma of the base of the tongue treated at the Alexis Vautrin Center 1978–1992. Bullet de Cancer 83: 90–96.CrossRefGoogle Scholar
Horwitz, E. M., Frazier, A. J., Martinez, A. A., Kaidan, R. D., Clarke, D. H., Lacerna, M. D. (1996) Excellent functional outcome in patients with squamous cell carcinoma of the base of tongue treated with external beam radiation and interstitial 125 J boost. Cancer 78: 948–957.3.0.CO;2-8>CrossRefGoogle Scholar
Housset, M., Baillet, F., Delanian, S., Brunel, P., Maulard, C., Michel-Langlet, P. (1991) Split course interstitial brachytherapy with a source shift: the results of a new iridium implant technique versus single course implants for salvage irradiation of base of tongue cancers in 55 patients. International Journal of Radiation Oncology, Biology, Physics 20: 965–971.CrossRefGoogle ScholarPubMed
Langlois, D., Hoffstetter, S., Pernot, M. (1988) Selection of patients for re-irradiation with local implants in carcinomas of the oropharynx and tongue. Acta Oncologia 27: 571–573.CrossRefGoogle ScholarPubMed
Matsumoto, K., Nakagawa, M., Higashi, H., Maeshiro, T., Tsuno, K., Mishina, M., Furata, T. (1992) Preliminary results of interstitial192 Iridium brachytherapy for malignant gliomas. Neurologia Medico-Chirurgia 32: 739–746.CrossRefGoogle ScholarPubMed
Mazeron, J. J., Langlois, D., Crook, J., Martin, M., Raynal, M., Peynegre, R. (1987) Salvage irradiation of epidermoid carcinoma of the oropharynx by 192 Iridium. Annales de Otolaryngologie et de Chirurgie Cervico-Faciale 104: 425–430.Google Scholar
Minsky, B., Botet, J., Gerdes, H., Lightdale, C. (1992) Ultrasound directed extrahepatic bile duct intraluminal brachytherapy. International Journal of Radiation Oncology, Biology, Physics 23: 165–167.CrossRefGoogle ScholarPubMed
Moscoso, J. F., Urke, M. L., Dalton, J., Wesson, M. F., Biller, H. (1994) Simultaneous interstitial radiotherapy with regional or free-flap reconstruction, following salvage surgery of recurrent head and neck carcinoma. Analysis of complications. Archives of Otolaryngology, Head and Neck Surgery 120: 965–972.CrossRefGoogle ScholarPubMed
Nag, S. J., Grecula, J., Ruymann, F. B. (1993) Aggressive chemotherapy, organ-preserving surgery, and high-dose-rate remote brachytherapy in the treatment of rhabdomyosarcoma in infants and young children. Cancer 72: 2769–2776.3.0.CO;2-C>CrossRefGoogle ScholarPubMed
Pernot, M., Malissard, L., Taghian, A., Hoffstetter, S., Luporsi, E., Forcard, J. J., Aletti, P., Bey, P. (1992) Velotonsillar squamous cell carcinoma: 277 cases by combined external radiation and brachytherapy – results according to extension, localization and dose rate. International Journal of Radiation Oncology, Biology, Physics 23: 715–723.CrossRefGoogle ScholarPubMed
Pernot, M., Aletti, P., Carolus, J. M., Marquis, I., Hoffstetter, S., Maaloul, F. (1995) Indications, techniques and results of postoperative brachytherapy in cancer of the oral cavity. Radiotherapy and Oncology 35: 186–192.CrossRefGoogle ScholarPubMed
Pierquin, B., Chassagne, D. (1962) La préparation nonradioactive en curiethérapie interstitielle et de contact. Journal de Radiologie 43: 65–72.Google Scholar
Regueiro, C. A., Millan, I., de la Torre, A., Valcarcel, F. J., Magallon, R., Fernandez, E., Aragon, G. (1995) Influence of boost technique (external beam radiotherapy or brachytherapy) on the outcome of patients with carcinoma of the base of the tongue. Acta Oncologia 34: 225–233.CrossRefGoogle ScholarPubMed
Seegenschmidt, M. H., Sauer, R., Fietkau, R., Iro, H., Chalal, J. A., Brady, L. W. (1992) Interstitial thermal radiation therapy: Five-year experience with head and neck tumours. Radiology 184: 795–804.CrossRefGoogle Scholar
Shibuya, H., Hoshina, M., Takeda, M., Matsumoto, S., Suzuki, S., Okada, N. (1993) Brachytherapy for stage I and II oral tongue cancer: An analysis of past cases focusing on control and complications. International Journal of Radition Oncology, Biology, Physics 26: 51–58.CrossRefGoogle Scholar