Skip to main content
Top
Published in: Discover Oncology 1/2023

Open Access 01-12-2023 | Brachytherapy | Research

Clinical application of 192Ir High-Dose-Rate brachytherapy in metastatic lymph nodes of the neck

Authors: Hongling Lu, Yunchuan Sun, Yan Gao, Li Xiao, Jianxi Zhou, Xiaoming Yin, Wei Guo, Kui Fan

Published in: Discover Oncology | Issue 1/2023

Login to get access

Abstract

Objective

The objective of this study was to investigate the safety and effectiveness of high-dose-rate brachytherapy as a treatment modality for recurrent or residual neck metastatic lymph nodes following external radiotherapy.

Methods

38 patients with 52 metastatic lymph nodes recurring or residual after previous external radiotherapy was completed to metastatic lymph nodes in the neck were collected from January 2019 to February 2022. High-dose-rate brachytherapy with 192Ir was performed with a prescribed dose of 20–30 Gy/1f (effective biological dose of 60–120 Gy), and imaging was performed at 1, 3, and 6 months after treatment to assess the local control rate and adverse effects of treatment.

Results

All 38 patients received completed treatment, and they were followed up for 6 months. 52 patients with neck lymph node metastases had an objective response rate.
(Complete response, CR + Partial response, PR) of 76.9%, which comprised 89.5% (34/38) for lymph nodes ≤ 3 cm and 42.9% (4/14) for > 3 cm, P = 0.028. P > 0.05 for CR + PR versus stable disease, SD + progressive disease, PD for lymph nodes between different subdivisions of the neck. Using the Radiation Therapy Oncology Group (RTOG) Acute Toxicity Scoring System, there were 6 cases of acute radioskin injuries of degree I and 4 cases of degree II with a 60% symptomatic relief rate.

Conclusions

High-dose-rate brachytherapy serves as a safe and effective method in treating recurrent residual neck metastatic lymph nodes in the field after external radiotherapy, exerting tolerable adverse effects.
Literature
1.
2.
go back to reference Temam S, et al. Salvage surgery after failure of very accelerated radiotherapy in advanced head-and-neck squamous cell carcinoma. Int J Radiat Oncol. 2005;62:1078–83.CrossRef Temam S, et al. Salvage surgery after failure of very accelerated radiotherapy in advanced head-and-neck squamous cell carcinoma. Int J Radiat Oncol. 2005;62:1078–83.CrossRef
3.
go back to reference Xiaoming Y, et al. Preliminary application of 192 Ir high-dose rate brachytherapy in postoperative recurrent colorectal cancer with intrapulmonary oligometastases. Chin J Radiol Med Prot. 2019;39:833–6. Xiaoming Y, et al. Preliminary application of 192 Ir high-dose rate brachytherapy in postoperative recurrent colorectal cancer with intrapulmonary oligometastases. Chin J Radiol Med Prot. 2019;39:833–6.
4.
go back to reference Ning Z, Guanghui C. Emerging predictive biomarkers for novel therapeutics in peripheral T-cell and natural killer/T-cell lymphoma. Front Immunol. 2016;14:895–901. Ning Z, Guanghui C. Emerging predictive biomarkers for novel therapeutics in peripheral T-cell and natural killer/T-cell lymphoma. Front Immunol. 2016;14:895–901.
5.
go back to reference He M, Cheng G, Zhao H, Zhao Z. EP-1984: Interstitial brachytherapy for the isolated lymph node metastasis from different solid cancers. Radiother Oncol. 2016;119:S938–9.CrossRef He M, Cheng G, Zhao H, Zhao Z. EP-1984: Interstitial brachytherapy for the isolated lymph node metastasis from different solid cancers. Radiother Oncol. 2016;119:S938–9.CrossRef
6.
go back to reference Hongling L, et al. EP-1984: interstitial brachytherapy for the isolated lymph node metastasis from different solid cancers. Radiother Oncol. 2016;119:S938–9.CrossRef Hongling L, et al. EP-1984: interstitial brachytherapy for the isolated lymph node metastasis from different solid cancers. Radiother Oncol. 2016;119:S938–9.CrossRef
7.
go back to reference Tselis N, et al. Hypofractionated accelerated CT-guided interstitial 192Ir-HDR-Brachytherapy as re-irradiation in inoperable recurrent cervical lymphadenopathy from head and neck cancer. Radiother Oncol. 2011;98:57–62.CrossRefPubMed Tselis N, et al. Hypofractionated accelerated CT-guided interstitial 192Ir-HDR-Brachytherapy as re-irradiation in inoperable recurrent cervical lymphadenopathy from head and neck cancer. Radiother Oncol. 2011;98:57–62.CrossRefPubMed
8.
go back to reference Kolotas C, et al. Reirradiation for recurrent neck metastases of head-and-neck tumors using CT-guided interstitial 192Ir HDR brachytherapy. Strahlenther Onkol. 2007;183:69–75.CrossRefPubMed Kolotas C, et al. Reirradiation for recurrent neck metastases of head-and-neck tumors using CT-guided interstitial 192Ir HDR brachytherapy. Strahlenther Onkol. 2007;183:69–75.CrossRefPubMed
9.
go back to reference Yu-liang J, et al. Implantation of 125I seeds for recurrence cervical node of head and neck tumor after external beam radiotherapy. Chin J Radiat Oncol. 2011;20:91–4. Yu-liang J, et al. Implantation of 125I seeds for recurrence cervical node of head and neck tumor after external beam radiotherapy. Chin J Radiat Oncol. 2011;20:91–4.
10.
11.
go back to reference Wattenberg MM, Fahim A, Ahmed MM, Hodge JW. Unlocking the combination: potentiation of radiation-induced antitumor responses with immunotherapy. Radiat Res. 2014;182:126–38.CrossRefPubMedPubMedCentral Wattenberg MM, Fahim A, Ahmed MM, Hodge JW. Unlocking the combination: potentiation of radiation-induced antitumor responses with immunotherapy. Radiat Res. 2014;182:126–38.CrossRefPubMedPubMedCentral
12.
go back to reference Wang J, et al. Radioactive 125I seed implantation for the treatment of recurrent cervical lymphatic metastases after radiotherapy: preliminary results in 17 cases. J Interv Radiol China. 2014;23:784–7. Wang J, et al. Radioactive 125I seed implantation for the treatment of recurrent cervical lymphatic metastases after radiotherapy: preliminary results in 17 cases. J Interv Radiol China. 2014;23:784–7.
13.
go back to reference Ashamalla H, Rafla S, Zaki B, Ikoro NC, Ross P. Radioactive gold grain implants in recurrent and locally advanced head-and-neck cancers. Brachytherapy. 2002;1:161–6.CrossRefPubMed Ashamalla H, Rafla S, Zaki B, Ikoro NC, Ross P. Radioactive gold grain implants in recurrent and locally advanced head-and-neck cancers. Brachytherapy. 2002;1:161–6.CrossRefPubMed
14.
go back to reference Fletcher GH. Clinical dose-response curves of human malignant epithelial tumours. Br J Radiol. 1973;46:1–12.CrossRefPubMed Fletcher GH. Clinical dose-response curves of human malignant epithelial tumours. Br J Radiol. 1973;46:1–12.CrossRefPubMed
15.
go back to reference Lee N, et al. Salvage Re-irradiation for recurrent head and neck cancer. Int J Radiat Oncol. 2007;68:731–40.CrossRef Lee N, et al. Salvage Re-irradiation for recurrent head and neck cancer. Int J Radiat Oncol. 2007;68:731–40.CrossRef
Metadata
Title
Clinical application of 192Ir High-Dose-Rate brachytherapy in metastatic lymph nodes of the neck
Authors
Hongling Lu
Yunchuan Sun
Yan Gao
Li Xiao
Jianxi Zhou
Xiaoming Yin
Wei Guo
Kui Fan
Publication date
01-12-2023
Publisher
Springer US
Published in
Discover Oncology / Issue 1/2023
Print ISSN: 1868-8497
Electronic ISSN: 2730-6011
DOI
https://doi.org/10.1007/s12672-023-00827-8

Other articles of this Issue 1/2023

Discover Oncology 1/2023 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine