%0 Journal Article
%T Salvage for cervical recurrences of head and neck cancer with dissection and interstitial high dose rate brachytherapy
%A Antonio Pellizzon
%A Jo£¿o Salvajoli
%A Luiz Kowalski
%A Andre Carvalho
%J Radiation Oncology
%D 2006
%I BioMed Central
%R 10.1186/1748-717x-1-27
%X The best approach for advanced head and neck cancer (HNC) is the combined modality using surgery, adjuvant radiotherapy with or without chemotherapy. For patients who refuse surgery, the superiority of radiation (RT) concurrent with chemotherapy (CHT) in local and regional tumor control has been established in several randomized studies and meta-analyses [1,2], but even for multimodality treated patients the recurrence rates above the clavicles occur in up to 20% of patients [3,4].Salvage therapy in HNC is still a controversy issue and the best combination approach is still to be defined. It seems that maximum debulking surgery combined to a primary or a second new course of RT can lead to a better local control (LC). Conversely, a new course of external beam radiotherapy (EBRT) for recurrent disease is always a problem and of limited feasibility because of the difficulty to spare adjacent normal tissues, resulting in undesirable late effects on the salivary glands, mandible, and muscles of mastication. In these cases the use of intra-operative interstitial implantation is an option, as it is ideally suited to deliver a high dose to a limited volume, thus minimizing sequelae and improving LC [5]. I-HDR can also increase total biological effective dose administered when compared to a second course of EBRT, the overall time is decreased and it is also a very conformal way of treatment, allowing protection of normal surrounding structures [6].In 1996 we started an institutional treatment policy of post-operative I-HDR for recurrent cervical carcinomas, with tumor control on the site of the primary, to take advantage of shortening the overall treatment time and conformability of the procedure.All patients admitted for treatment at the Radiation Oncology and Head and Neck Surgery Departments, Hospital do Cancer A.C. Camargo, S£¿o Paulo, Brazil, from October 1994 to June 2004, were retrospectively selected. The criteria for including patients in the study were: recurrent c
%U http://www.ro-journal.com/content/1/1/27