Abstract 434P
Background
Although surgery has traditionally been the first-line approach, brachytherapy (BT) has demonstrated comparable disease control with the added benefits of better functional outcomes and cosmesis in early-stage head and neck cancers (HNC). This study reports long-term outcomes in patients with HNC treated with brachytherapy.
Methods
This retrospective study was conducted in tertiary care oncology centre in India. We reviewed the charts of 53 patients with early or locally advanced HNC who underwent brachytherapy during a period of 2010 to 2023. Surgery was not performed due to unresectability, inoperability owing to medical comorbidities, or patient preference. The primary endpoints were overall survival (OS) and disease-free survival (DFS).
Results
The median DFS, 3-year DFS, and 5-year DFS were 45.0 months, 58.9% and 42.9%, respectively. The median OS, 3-year OS, and 5-year OS were 89.9 months, with survival rates of 75.5% and 50.9%, respectively. Brachytherapy for newly diagnosed malignancies significantly improved DFS compared to re-irradiation (Re-RT) for recurrent malignancies (median DFS 71.9 months vs. 12.5 months; p = 0.002). For Re-RT, BT in second primary (SP) malignancies resulted in better DFS than in recurrent malignancies (median DFS 20.0 months vs. 6.5 months; p = 0.004). Moreover, BT as a boost dose post-EBRT showed superior DFS compared to full-dose BT (median DFS 71.9 months vs. 28.6 months; p = 0.022). In terms of OS, newly diagnosed cases treated with BT had markedly better outcomes than those receiving Re-RT for recurrent malignancies (median OS not reached vs. 30.3 months; p < 0.001). Within Re-RT, BT for recurrent malignancies exhibited better OS than SP malignancies (median OS 40.4 months vs. 25.1 months; p = 0.002). BT as a full dose also outperformed boost dose BT in terms of OS (median OS not reached vs. 40.4 months; p = 0.009). T stage and N stage did not show significant impacts on DFS or OS.
Conclusions
Brachytherapy stands out as a highly effective treatment for head and neck cancer, particularly for newly diagnosed cases and as an adjunct to EBRT. Its superior survival outcomes and minimal invasiveness make it an excellent option for patients, offering substantial benefits in disease control.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.