Multi-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer. Academic Article uri icon

Overview

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.

authors

  • Luginbuhl, Adam
  • Calder, Alyssa
  • Kutler, David I.
  • 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
  • Curry, Joseph
  • Cognetti, David
  • Bar-Ad, Voichita

publication date

  • November 26, 2021

Identity

PubMed Central ID

  • PMC8660666

Scopus Document Identifier

  • 85097627415

Digital Object Identifier (DOI)

  • 10.1158/1078-0432.CCR-20-1695

PubMed ID

  • 34900741

Additional Document Info

volume

  • 11