Multi-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer

IntroductionSurgery 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...

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Autores principales:	Adam Luginbuhl, Alyssa Calder, David Kutler, Chad Zender, Trisha Wise-Draper, Jena Patel, Michael Cheng, Vidhya Karivedu, Tingting Zhan, Bhupesh Parashar, Shuchi Gulati, Min Yao, Pierre Lavertu, Vinita Takiar, Alice Tang, Jennifer Johnson, William Keane, Joseph Curry, David Cognetti, Voichita Bar-Ad
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	head and neck cancer recurrent surgery brachytherapy Cesium-131 reirradiation head and neck Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/ba29a7da59e44f3bb050998caaaec7d4
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spelling	oai:doaj.org-article:ba29a7da59e44f3bb050998caaaec7d42021-12-01T04:21:37ZMulti-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer2234-943X10.3389/fonc.2021.786216https://doaj.org/article/ba29a7da59e44f3bb050998caaaec7d42021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.786216/fullhttps://doaj.org/toc/2234-943XIntroductionSurgery 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 MaterialsFindings 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.ResultsForty-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.ConclusionsAmong 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 RegistrationClinicalTrials.gov, identifiers NCT02794675 and NCT02467738.Adam LuginbuhlAlyssa CalderDavid KutlerChad ZenderTrisha Wise-DraperJena PatelMichael ChengVidhya KariveduTingting ZhanBhupesh ParasharShuchi GulatiMin YaoPierre LavertuVinita TakiarAlice TangJennifer JohnsonWilliam KeaneJoseph CurryDavid CognettiVoichita Bar-AdFrontiers Media S.A.articlehead and neck cancerrecurrentsurgerybrachytherapyCesium-131reirradiation head and neckNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	head and neck cancer recurrent surgery brachytherapy Cesium-131 reirradiation head and neck Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	head and neck cancer recurrent surgery brachytherapy Cesium-131 reirradiation head and neck Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Adam Luginbuhl Alyssa Calder David Kutler Chad Zender Trisha Wise-Draper Jena Patel Michael Cheng Vidhya Karivedu Tingting Zhan Bhupesh Parashar Shuchi Gulati Min Yao Pierre Lavertu Vinita Takiar Alice Tang Jennifer Johnson William Keane Joseph Curry David Cognetti Voichita Bar-Ad Multi-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer
description	IntroductionSurgery 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 MaterialsFindings 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.ResultsForty-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.ConclusionsAmong 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 RegistrationClinicalTrials.gov, identifiers NCT02794675 and NCT02467738.
format	article
author	Adam Luginbuhl Alyssa Calder David Kutler Chad Zender Trisha Wise-Draper Jena Patel Michael Cheng Vidhya Karivedu Tingting Zhan Bhupesh Parashar Shuchi Gulati Min Yao Pierre Lavertu Vinita Takiar Alice Tang Jennifer Johnson William Keane Joseph Curry David Cognetti Voichita Bar-Ad
author_facet	Adam Luginbuhl Alyssa Calder David Kutler Chad Zender Trisha Wise-Draper Jena Patel Michael Cheng Vidhya Karivedu Tingting Zhan Bhupesh Parashar Shuchi Gulati Min Yao Pierre Lavertu Vinita Takiar Alice Tang Jennifer Johnson William Keane Joseph Curry David Cognetti Voichita Bar-Ad
author_sort	Adam Luginbuhl
title	Multi-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer
title_short	Multi-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer
title_full	Multi-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer
title_fullStr	Multi-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer
title_full_unstemmed	Multi-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer
title_sort	multi-institutional study validates safety of intraoperative cesium-131 brachytherapy for treatment of recurrent head and neck cancer
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/ba29a7da59e44f3bb050998caaaec7d4
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Multi-Institutional Study Validates Safety of Intraoperative Cesium-131 Brachytherapy for Treatment of Recurrent Head and Neck Cancer

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