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High dosage brachytherapy obtains excellent results in head and neck tumors
March 30, 2009High-dosage perioperative brachytherapy (applied within the surgical process) obtains excellent results in the treatment of head and neck tumours, at the same time as reducing the period of radiation. These are the conclusions of research undertaken jointly by three Departments at the University of Navarra Hospital and which was published in the latest issue of Brachytherapy, official journal of the American Society of Brachytherapy.
The work describes the application of this new radiotherapy technique to 40 patients between 2000 and 2006. Given the size of the sample, the article is a description of the greatest number of patients treated with high-dosage brachytherapy for head and neck tumours in world medical literature. According to results, after a seven-year follow-up, the illness was controlled in 86% of the cases and the percentage of survival was 52%.
In concrete, the research focused on the treatment of tumours in the oral cavity, those affecting the tongue and the floor of the mouth, and those in the oropharyngeal region, such as tumours of the tonsils.
Involved in the study was a multidisciplinary team of seven specialists from three departments at the University of Navarra Hospital: the Radiotherapy Department, the Department of Oral and Maxillofacial Surgery and the Ear, Nose and Throat Department.
Intensifying radiation dosage
As is known, brachytherapy is a radiotherapy treatment involving the placing of radioactive sources within the tumour or nearby.
In the case in hand, the work analysed the application of brachytherapy as complementary post-surgery treatment, explained Doctor Rafael Martínez-Monge, Director of the Radiotherapy Department. Some cases of head and neck tumours require the application of radiotherapy after the surgical operation. Using this technique, they have managed to intensify the radiation dosage with the goal of reducing relapse rates.
In certain treatments, brachytherapy provides better end-result possibilities than conventional radiotherapy. The procedure enables the administration of doses that would not be easily achieved using other techniques, due to toxic effects, explained the specialist from the University of Navarra Hospital.
Two weeks of treatment less
Moreover, the use in brachytherapy of high dosages involves a series of benefits for the patient as regards the overall treatment. The great advantage, points out Doctor Martínez-Monge, is the reduction of total time. While conventional radiotherapy treatment lasted seven weeks, administering part of the radiation through brachytherapy can take two weeks less.
This technique also manages to reduce the time of radiation compared to treatment with low dosage brachytherapy. Thanks to the existence of new sources of radiation, the treatment is released in a matter of minutes. Before the patient under brachytherapy treatment carried the radioactive source for several days and, thus, had to be isolated in a lead-lined room, with limitations on visits and nursing care. With high-dosage brachytherapy, however, the patient is only radioactive during the actual administration of the treatment; as such, the rest of the time can be spent in a conventional room.
For the administration of this technique it is necessary to prepare the affected region during the surgical operation. On extirpating the tumour, the surgeon covers the surgery zone - the area with greatest possibilities for relapse - with a series of plastic tubes which are subsequently filled with radioactive material, the aim being to effect a highly selective and precise radiation. Brachytherapy is introduced through these tubes, one end of which appears at the surface of the skin, like a drainpipe, explained Doctor Rafael Martínez-Monge. These tubes are connected to a machine that administers the treatment according to a computer programme personalised for each patient, he added.
Application to other types of tumour
Apart from perioperative high-dosage brachytherapy treatment for head and neck tumours, the University of Navarra Hospital has been working on the application of this procedure to other oncological processes for a number of years. There are a number of studies under way on its use in gynaecological tumours and sarcomas, amongst others. Since 2000 about 400 patients, with different types of tumours, have been treated with this technique.
Elhuyar Fundazioa
Involved in the study was a multidisciplinary team of seven specialists from three departments at the University of Navarra Hospital: the Radiotherapy Department, the Department of Oral and Maxillofacial Surgery and the Ear, Nose and Throat Department.
Intensifying radiation dosage
As is known, brachytherapy is a radiotherapy treatment involving the placing of radioactive sources within the tumour or nearby.
In the case in hand, the work analysed the application of brachytherapy as complementary post-surgery treatment, explained Doctor Rafael Martínez-Monge, Director of the Radiotherapy Department. Some cases of head and neck tumours require the application of radiotherapy after the surgical operation. Using this technique, they have managed to intensify the radiation dosage with the goal of reducing relapse rates.
In certain treatments, brachytherapy provides better end-result possibilities than conventional radiotherapy. The procedure enables the administration of doses that would not be easily achieved using other techniques, due to toxic effects, explained the specialist from the University of Navarra Hospital.
Two weeks of treatment less
Moreover, the use in brachytherapy of high dosages involves a series of benefits for the patient as regards the overall treatment. The great advantage, points out Doctor Martínez-Monge, is the reduction of total time. While conventional radiotherapy treatment lasted seven weeks, administering part of the radiation through brachytherapy can take two weeks less.
This technique also manages to reduce the time of radiation compared to treatment with low dosage brachytherapy. Thanks to the existence of new sources of radiation, the treatment is released in a matter of minutes. Before the patient under brachytherapy treatment carried the radioactive source for several days and, thus, had to be isolated in a lead-lined room, with limitations on visits and nursing care. With high-dosage brachytherapy, however, the patient is only radioactive during the actual administration of the treatment; as such, the rest of the time can be spent in a conventional room.
For the administration of this technique it is necessary to prepare the affected region during the surgical operation. On extirpating the tumour, the surgeon covers the surgery zone - the area with greatest possibilities for relapse - with a series of plastic tubes which are subsequently filled with radioactive material, the aim being to effect a highly selective and precise radiation. Brachytherapy is introduced through these tubes, one end of which appears at the surface of the skin, like a drainpipe, explained Doctor Rafael Martínez-Monge. These tubes are connected to a machine that administers the treatment according to a computer programme personalised for each patient, he added.
Application to other types of tumour
Apart from perioperative high-dosage brachytherapy treatment for head and neck tumours, the University of Navarra Hospital has been working on the application of this procedure to other oncological processes for a number of years. There are a number of studies under way on its use in gynaecological tumours and sarcomas, amongst others. Since 2000 about 400 patients, with different types of tumours, have been treated with this technique.
Elhuyar Fundazioa
Brachytherapy Current Events and Brachytherapy News RSSTask force develops new radiation guidelines for brachytherapy
Radiation dose delivered to the prostate and nearby organs in every brachytherapy procedure should be carefully analyzed using post-implant CT or MRI and uniformly documented in every patient.
Hormone therapy for prostate cancer patients with heart conditions linked to increased death risk
Men with coronary artery disease-induced congestive heart failure or heart attack who receive hormone therapy before or along with radiation therapy for treatment of prostate cancer have an associated increased risk of death.
Study shows seed implants a suitable prostate cancer treatment option for men of all ages
Men diagnosed with prostate cancer have a number of treatments to choose from, but it's a daunting task to figure out the right mix of therapies for an individual patient.
Prostate cancer patients disease free after 5 years likely to be disease free after 10 years
Prostate cancer patients who receive brachytherapy and remain free of disease for five years or greater are unlikely to have a recurrence at 10 years.
External beam partial breast irradiation most cost-effective treatment
External beam partial breast irradiation (EB-PBI) is the most cost-effective method for treating postmenopausal women with early-stage breast cancer based on utilities, recurrence risks and costs when compared to whole breast radiotherapy (WBRT) and brachytherapy partial breast irradiation (brachy-PBI).
Long-term study shows low oxygen levels in prostate tumors can predict recurrence
Fox Chase Cancer Center researchers have discovered that low-oxygen regions in prostate tumors can be used to predict a rise in prostate-specific antigen (PSA) levels, a marker of tumor recurrence in prostate cancer.
Radiation device in the breast reduces complications for early stage breast cancer patients
A new study shows that the SAVI™ applicator, a small, expandable device inserted inside the breast to deliver partial breast irradiation, carries a low infection risk, a potential complication of such devices.
Agent Orange exposure increases veterans' risk of aggressive recurrence of prostate cancer
Veterans exposed to Agent Orange are at increased risk of aggressive recurrence of prostate cancer, researchers report.
Early results favorable for 5-day radiation treatment of early stage prostate cancer
Preliminary results show that a shortened course of radiation therapy for prostate cancer called stereotactic body radiation therapy (SBRT) provides good PSA response for early-stage prostate cancer and has the same side effects as other treatments.
Family history of prostate cancer does not affect some treatment outcomes
In a first of its kind study, a first-degree family history of prostate cancer has no impact on the treatment outcomes of prostate cancer patients treated with brachytherapy (also called seed implants), and patients with this type of family history have clinical and pathologic characteristics similar to men with no family history at all, according to a January 1 study in the International Journal of Radiation Oncology*Biology*Physics, the official journal of the American Society for Radiation Oncology.
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