Salvage brachytherapy as a modern reirradiation technique for local cancer failure: The Phoenix is reborn from its ashes.

Fiche publication

Date publication

mai 2018

Journal

Cancer radiotherapie : journal de la Societe francaise de radiotherapie oncologique

Auteurs

Membres identifiés du Cancéropôle Est :
Dr MARTIN Etienne , Dr PEIGNAUX Karine , Pr TRUC Gilles , Dr QUIVRIN Magali , Dr ROUFFIAC-THOUANT Magali , Dr VULQUIN Noémie

Tous les auteurs :
Quivrin M, Peignaux-Casasnovas K, Martin É, Rouffiac M, Thibouw D, Chevalier C, Vulquin N, Aubignac L, Truc G, Créhange G

Lien Pubmed

https://www.ncbi.nlm.nih.gov/pubmed/29859761

Résumé

The treatment of local recurrence of a previously irradiated cancer or a second cancer arising in-field remains challenging. Ultimately, the objective of salvage therapy is to control disease while ensuring minimal collateral damage, thereby optimizing both cancer and toxicity outcomes. Reirradiation has historically been associated with unacceptable toxicity and a limited benefit. Brachytherapy offers the best dose distribution and a high radiation dose to the target volume while better protecting surrounding previously irradiated healthy tissues. The management of local cancer recurrence in irradiated areas should be planned through multidisciplinary discussions and patients should be selected carefully. This overview of the literature describes brachytherapy as a reirradiation treatment in local recurrences of previously irradiated prostate, breast, head and neck and rectal cancers, or second primary cancers occurring in-field. For these cancers, the prognosis and therapeutic challenges are quite different and depend on the type of primary cancer. However, current data confirm that brachytherapy reirradiation is feasible and has acceptable toxicity.