CC BY-NC-ND 4.0 · J Neurol Surg Rep 2019; 80(02): e23-e26
DOI: 10.1055/s-0039-1687848
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Cesium-131 Interstitial Brachytherapy for Recurrent Malignancies of Skull Base

Corey Savard
1  Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Gregory Epps
2  Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Voichita Bar Ad
3  Department of Radiation Oncology–Head and Neck Cancer, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Joseph Curry
2  Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
James J. Evans
4  Department of Neurosurgery–Neuro-Oncologic and Stereotactic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Christopher J. Farrell
4  Department of Neurosurgery–Neuro-Oncologic and Stereotactic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Gurston Nyquist
2  Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
,
Adam Luginbuhl
2  Department of Otolaryngology–Head and Neck Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, United States
› Author Affiliations
Further Information

Publication History

20 December 2018

20 February 2019

Publication Date:
09 April 2019 (online)

  

Abstract

Background Recurrent malignancy of the skull base poses a treatment challenge due to a lack of treatment options and potential for damage to surrounding structures.

Methods Case report of two patients with recurrent nasopharyngeal carcinoma (NPC) of skull base previously treated with adjuvant chemoradiotherapy using intensity-modulated radiation therapy (IMRT).

Results In both cases, the recurrent tumor was treated with endoscopic surgical resection and intraoperative cesium-131 (Cs-131) interstitial brachytherapy (IBT). Total dose delivered to tumor bed was 57 and 60 Gy, respectively. With a half- life of 9 days, the majority of the radiation dose had been delivered within the first 40 days following implant and there have been no treatment-related complications reported.

Conclusion Intraoperative Cs-131 IBT is a feasible adjuvant treatment option for patients with recurrent malignancies of the skull base. These are the first known cases of Cs-131 IBT used for recurrent NPC.

Financial Disclosure

The authors have indicated they have no financial relationships relevant to this article to disclose.