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Brachytherapy is an interesting irradiation technique for the management of head and neck cancers. After the heyday of the 1980s-1990s, brachytherapy has progressively lost its attractiveness, but the development of multimodal imaging, of new applicators adapted to tumors and of dose optimization processes, including hypofractionation possibilities, have led to an improvement of tumor control, and have led to revisit the indications of brachytherapy. This study evaluated the efficiency in terms of local control, survival and toxicity of irradiation of head and neck tumors by HDR brachytherapy.

We retrospectively reviewed the medical records of patients between January 2012 and August 2022, who received endocavitary or interstitial HDR brachytherapy as primary or salvage treatment for histologically proven head and neck cancer. Patients were indexed on the Hosix hospital network database, as well as the TPS ARIA, and were stratified according to age, sex, tumor location, technique and radiation dose. The data were processed using Excel software.Survival was estimated according to Kaplan-Meier curves and toxicity was graded according to the 4th version of the Common Terminology Criteria for Adverse Events CTCAE.

Twenty-three patients underwent brachytherapy for their Head and neck cancer. The median age of our population was 51.5 years and the sex ratio M/F was 6.3. 14 tumors were located in the lower lip, one in the tongue, and 8 in the nasopharynx. For patients with squamous cell carcinoma of the lower lip;7 had exclusive brachytherapy and the others had postoperative brachytherapy because of close or positive margins. Only one patient of our study had exclusive brachytherapy for recurrent SCC of the tongue. 8 patients with non-metastatic recurrent undifferentiated nasopharyngeal carcinoma in an irradiated area were re-irradiated with brachytherapy for curative purpose. The median irradiation dose was 33.44 Gy on the reference isodose. With a median follow-up of 40.57 months, all patients were alive with complete remission, with no evidence of local or distant recurrence. 44% of patients had grade I radiodermatitis and no grade II-III toxicity occurred.

Brachytherapy is the most conformal irradiation technique allowing satisfactory cancer results; however, insufficient teaching, inadequate promotion, and an aging image of brachytherapy are the three major issues affecting its inclusion in the anticancer therapeutic arsenal. It’s essential that brachytherapy be re known in order to restore its value for patients who will be able to benefit from it in accordance with the indications specified during multidisciplinary concertation meetings.