Table 2.

Overview of studies treating recurrent head and neck squamous cell carcinoma using surgery with brachytherapy

Author, year	N	Brachytherapy	Total dose	Surgical resection	Results	Complications
Henderson, 2016 [6]	23	Ir 192; HDR Cs-131; LDR	Mean: 21 Gy Mean: 81 Gy	Yes	Not mentioned	50% toxicity in HDR pts 30% toxicity in LDR pts
Narayana, 2007 [9]	30	HDR	34 Gy (+ surgery) 20 Gy (+ EBRT) 40 Gy (only BT)	60% Yes 40% No	LC at 2 years: 71% (88% + surgery, 40% – surgery) OS at 2 years: 63%	33% grade 2-3 toxicity
Martinez-Fernandez, 2017 [10]	63	HDR	Total: 32 or 40 Gy	Yes	LC at 15 years: 41% OS at 15 years: 12%	51% grade ≥ 3 toxicity
Schiefke, 2008 [11]	13	HDR	Median: 30 Gy	Yes	OS at 2 years: 65% LR failure in 38%	69% acute toxicity 31% late toxicity
Scala, 2013 [13]	76	HDR	Median rate: 1,200 cGy	Yes	LC at 2 years: 62% OS at 2 years: 42%	No grade 3-4 toxicity
Rudzianskas, 2012 [20]	30	Ir 192; HDR	Total: 30 Gy	43% Yes 57% No	LC at 2 years: 77% OS at 2 years: 62% Non-surgical group: LC at 2 years: 47% OS at 2 years: 35%	10% acute grade 2-3 10% late grade 2-4
Park, 1991 [21]	35	I 125; LDR	Mean rate: 8,280 cGy	Yes	OS at 2 years: 38% OS at 5 years: 29%	36% acute and/or late toxicity
Pellizzon,2005 [22]	42	Ir 192; HDR	Median: 24 Gy	Yes	Crude LC 57% OS at 5 years: 52.5%	19% acute and/or late toxicity
Pham, 2015 [23]	18	Cs 131; LDR	Median: 80 Gy	Yes	OS at 18 mos: 45% LR failure in 33%	11% grade 3 toxicity
Teckie, 2013 [41]	57	Ir 192; HDR	Median: 15 Gy	Yes	OS at 3 years: 32% LR failure in 46%	37% grade 3 No grade 4-5 toxicity
Perry, 2010 [42]	34	Ir 192; HDR	Median: 15 Gy	Yes	OS at 2 years: 55%	29% grade 3-4 toxicity

Ir 192 – Iridium 192; I 125 – Iodine 125; Cs 131 – Cesium 131; Gy – Gray; LDR – low-dose-rate; HDR – high-dose-rate; EBRT – external beam radiation therapy; BT – brachytherapy; LC – local control; LR – locoregional; OS – overall survival