Clinical outcomes after interstitial brachytherapy for early-stage nasal squamous cell carcinoma

Publication date: Available online 23 July 2017
Source:Brachytherapy
Author(s): Warren Bacorro, Alexandre Escande, Stéphane Temam, Isabelle Dumas, Emilie Routier, Marie-Catherine Gensse, Pierre Blanchard, François Janot, Christine Mateus, Yungan Tao, Caroline Robert, Eric Deutsch, Christine Haie-Meder, Cyrus Chargari
PurposeRadiotherapy of nasal carcinomas results in cure rates comparable to surgery, with anatomic preservation and good cosmesis. Brachytherapy (BT) overcomes difficulties with dosimetric coverage and affords a localized and highly conformal irradiation. We report our experience of BT for early-stage nasal squamous cell carcinomas (SCCs).Methods and MaterialsClinical data, BT parameters, and outcome of consecutive patients treated by interstitial BT in our institute between December 1982 and April 2015 for a localized nasal SCC were examined. A total of 34 patients with newly diagnosed T1-2N0-1 nasal skin (n = 22) or nasal cavity (n = 12) SCC were identified. Implantation and dosimetry were done according to the Paris system rules. Low-dose-rate (n = 30) or pulsed-dose-rate (n = 4) techniques were used. Median dose was 70 Gy (64–75 Gy). Sites of tumor recurrence, toxicity rates, and cosmesis outcome were examined.ResultsMedian followup time was 89 months. All patients achieved complete response. Five patients experienced local failure, with a median interval of 9 months (range, 5–12 months). Grade 3 acute reactions were reported in 2 patients (6%). Most delayed complications were mild to moderate, and good or fair cosmesis was achieved in 97%. Estimated local failure-free survival and disease-free survival rates at 5 year were 85% (95% CI = 68–94%) and 76% (95% CI = 58–88%), respectively.ConclusionsInterstitial BT is effective for selected nasal SCCs, with durable local control, acceptable toxicity, and good cosmesis.



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