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The following is a summary of “GEC-ESTRO recommendations for head & neck cancer brachytherapy (interventional radiotherapy): 2nd update with focus on HDR and PDR,” published in the September 2024 issue of Oncology by Guinot et al.

Brachytherapy (BT) plays a critical role in the multidisciplinary treatment of Head and Neck (H&N) cancers, offering significant advantages as an organ- and function-preserving modality. Recent advancements in technology have revolutionized this treatment, with low-dose-rate (LDR) approaches being largely replaced by more advanced systems such as pulsed dose rate (PDR) and high-dose-rate (HDR) techniques. These systems utilize modern remote afterloading and stepping source equipment, allowing for precise dose delivery and reduced treatment times. Enhanced imaging technologies and integration of three-dimensional (3D) treatment planning systems further support the accurate targeting of tumors while minimizing exposure to surrounding healthy tissues. 

This paper serves as an update to the previous recommendations from the GEC-ESTRO (Groupe Européen de Curiethérapie – European Society for Radiotherapy and Oncology) for the treatment of head and neck tumors, with a specific focus on squamous cell carcinomas, which represent the most common histological subtype in this region. The review synthesizes the latest findings from published studies, offering updated guidelines for applying brachytherapy across various tumor sites within the H&N region. Key factors such as patient selection criteria, clinical outcomes, and optimal dosing strategies are discussed in detail, providing clinicians with a clear framework for decision-making. Furthermore, the efficacy of modern BT in achieving local control, improving survival rates, and preserving organ function is highlighted, positioning it as a crucial component in the treatment arsenal against H&N cancers. This comprehensive review underscores the importance of staying abreast of technological advancements and treatment innovations to ensure optimal patient outcomes. It reinforces the critical role of brachytherapy in contemporary oncological practice.

Source: sciencedirect.com/science/article/pii/S0167814024035114