The role of high-dose-rate and pulsed-dose-rate brachytherapy in the management of recurrent or residual stomal tumor after total laryngectomy

Objectives/Hypothesis: The main purpose of the study was to assess the role and efficacy of high‐dose‐rate (HDRBT) and pulsed‐dose‐rate (PDRBT) brachytherapy in the palliative treatment of recurrent or residual stomal tumor after total laryngectomy. Study Design: We aimed at presenting a series of 22 consecutive patients treated in the Department of Otolaryngology, Head and Neck Surgery of Poznań University of Medical Sciences, and in the Brachytherapy Department of Greater Poland Cancer Center. Methods: In 16 patients PDRBT was used and in six patients HDRBT was used. In three patients, BT procedures were performed in combination with simultaneous chemotherapy. Two patients were additionally treated with interstitial hyperthermia. In 16 patients, surgical cytoreduction of the tumor preceded the catheters placement. In six patients, a second course of BT was performed due to neck metastases. All patients were regularly followed up within 6 months. Local control, complications, and survival were assessed. Results: Complete and partial remissions 6 months after finishing the treatment were achieved in four (20%) patients, while survival rates 24 months after BT were estimated for 22%. Severe late complications occurred in two (9%) patients. Conclusions: The results of our study show that HDRBT and PDRBT are feasible in previously irradiated patients with recurrent or residual stomal tumor after total laryngectomy. They provide acceptable toxicity and good palliative effect. Laryngoscope, 2013