Authors' objectives: The principal aim of this report was to assess the effectiveness and safety of high-dose-rate brachytherapy in treatment of tumours of the head and neck. The specific objectives were twofold: 1) to assess the benefits in terms of loco-regional control, distant metastasis, survival, safety, and costs with respect to conventional treatments (external radiotherapy, surgical excision, chemotherapy and low rate brachytherapy); and 2) to assess the benefits with respect to new treatment modalities (intensity modulated radiation therapy, stereotactic radiotherapy, etc.).

Authors' recommendations: The results of the studies reviewed leave important doubts as to the application of HDR-BT as a definitive treatment for primary tumours of the head and neck. The results are not consistent in terms of their equivalence for controlling relapses in tumours of the tongue, and there are studies which show a clear trend towards an increase in late grade III or IV toxicity. The nasopharyngeal studies indicate that local control may be greater with fractionated stereotactic radiosurgery or three-dimensional conformal radiation therapy, and there are many authors who feel that these and other tumours of the head and neck could be more effectively treated with treatment plans and/or modalities other than HDR-BT. An evidence-based, clinical practice guideline should be drawn up to address the various alternatives for treatment of cancer of the head and neck, including different plans, guidelines and radiation dosage. In view of the lack of quality studies, this is admittedly the only way of drawing up recommendations for the treatment of these tumours.

Project Status: Completed

Year Published: 2012

URL for published report: http://www.sergas.es/Docs/Avalia-t/CT2012-03Braquiterapia.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Spain

Organisation Name: Scientific Advice Unit, avalia-t; The Galician Health Knowledge Agency (ACIS)

Contact Address: Conselleria de Sanidade, Xunta de Galicia, San Lazaro s/n 15781 Santiago de Compostela, Spain. Tel: 34 981 541831; Fax: 34 981 542854;

Contact Name: avalia-t@sergas.es

Contact Email: avalia-t@sergas.es

Copyright: Galician Agency for Health Technology Assessment (AVALIA-T)