Brachytherapy in reirradiation of locally recurrent nasopharyngeal cancer: case report

Purpose Nasopharyngeal carcinoma NPC is a most cancer of head and neck in North Africa and South East Asia The risk of local recurrence after treatment is higher Reirradiation can be difficult and limited by the constraints of doses to organs at risk already irradiated The aim of this study was to determine the role of brachytherapy in safety reirradiation of recurrent NPC Methods and Materials From to five patients were reirradiated for local recurrence nasopharyx cancer with or without external beam radiotherapy EBRT Results The median age was years all were male four patients had World Health Organization Class III histology and one with nasopharyx cancer type I Two and patients had recurrent Stage I II III respectively Median time to reirradiation was months Four patients received combined modality treatment consisting of external beam radiotherapy EBRT with chemotherapy followed by intracavitary brachytherapy High Dose Rate HDR boost one patient received intracavitary brachytherapy alone for dosimetric constraints for organs at risk The total radiation dose EQD was between and Gy All patients received concomitant chemotherapy and two neoadjuvant chemotherapy The median follow up for all patients was months one patient developed an immobility of the soft palate and another had grade II trismus Conclusion Brachytherapy alone or after EBRT may play an important role in reirradiation of locally recurrent NPC with acceptable toxicity