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Purpose <p>Delineating boundaries for salvage brachytherapy in recurrent/second primary head and neck squamous cell carcinoma after radiotherapy is frequently compromised under standard white light. This pilot study evaluates the feasibility, technical success and safety of intraoperative NBI to guide catheter and surface mould application.</p> Methods <p>This prospective feasibility case series evaluated four patients presenting with localized, small-volume HNSCC within high-dose overlapping fields. Three patients underwent NBI-guided interstitial High-Dose-Rate (HDR) brachytherapy; one received an NBI-guided custom surface mould. Real-time target encapsulation, toxicity tracking via CTCAE v5.0, response metrics via RECIST v1.1, and 1-year surveillance were implemented.</p> Results <p>Technical feasibility was 100%. Real-time NBI toggle allowed immediate adjustment by highlighting malignant lesion against pale post-radiation scars, preventing marginal misses. At 8–12 weeks, clinical and FDG PET-CT reviews demonstrated a 100% complete response. Descriptive 1-year local control and disease-free survival rates were 100%. No acute or late toxicities or mandibular osteoradionecrosis occurred; acute mucositis was limited to Grade 1–2.</p> Conclusion <p>NBI guidance for salvage brachytherapy is technically feasible and highly effective for precise margin definition. Given the small sample size and short follow-up, these preliminary technical validations warrant larger randomized trials.</p>

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Narrow Band Imaging (NBI)-Guided Brachytherapy in Recurrent or Second Primary Head and Neck Squamous Cell Carcinoma Following Full-Dose Radiotherapy: a Technical Demonstration and Feasibility Pilot Study

  • 期刊论文

  • 发表日期：

    2026年7月27日

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  • Sreejith VS,
  • Vikas Gupta,
  • Rajeev Chugh,
  • Anandita Gupta,
  • Sankalp Singh,
  • Salil Kumar Gupta,
  • Meenakshi Rajput,
  • Ramneek Kaur,
  • Bathula Prem Kumar

摘要

Purpose

Delineating boundaries for salvage brachytherapy in recurrent/second primary head and neck squamous cell carcinoma after radiotherapy is frequently compromised under standard white light. This pilot study evaluates the feasibility, technical success and safety of intraoperative NBI to guide catheter and surface mould application.

Methods

This prospective feasibility case series evaluated four patients presenting with localized, small-volume HNSCC within high-dose overlapping fields. Three patients underwent NBI-guided interstitial High-Dose-Rate (HDR) brachytherapy; one received an NBI-guided custom surface mould. Real-time target encapsulation, toxicity tracking via CTCAE v5.0, response metrics via RECIST v1.1, and 1-year surveillance were implemented.

Results

Technical feasibility was 100%. Real-time NBI toggle allowed immediate adjustment by highlighting malignant lesion against pale post-radiation scars, preventing marginal misses. At 8–12 weeks, clinical and FDG PET-CT reviews demonstrated a 100% complete response. Descriptive 1-year local control and disease-free survival rates were 100%. No acute or late toxicities or mandibular osteoradionecrosis occurred; acute mucositis was limited to Grade 1–2.

Conclusion

NBI guidance for salvage brachytherapy is technically feasible and highly effective for precise margin definition. Given the small sample size and short follow-up, these preliminary technical validations warrant larger randomized trials.