title: Iodine-125 seed implantation as an adjunct to surgery in advanced recurrent squamous cell cancer of the head and neck.
abstract: Survival for extensive recurrent squamous cell carcinomas of the head and neck remains poor, with the major cause of death being local recurrence. Surgical implantation of iodine-125 interstitial seeds allows tumoricidal doses of radiation to be delivered to residual tumor while minimizing radiation doses to the surrounding tissues. From 1978 to 1988, 39 implantations were performed on 35 patients for extensive recurrent squamous cell carcinoma of the head and neck. The decision for implantation was based on positive margins or close to resection margins from frozen sections after salvage resection. The determinate 5-year disease-free survival was 41%, with both the overall and no evidence of disease 5-year survivals being 29%. Significant complications occurred in 36% of all cases. This figure increased to 56% when flap reconstruction was required. Possible reasons for this seemingly high complication rate are discussed. Considering the advanced nature of these recurrent carcinomas, surgical resection with iodine-125 seed implantation appears to be an effective method of managing disease that might otherwise be judged unresectable and treated for palliation only.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Hospital, Baltimore, Md.
authors.forename: R I
authors.initials: RI
authors.lastname: Park
authors.forename: F Z
authors.initials: FZ
authors.lastname: Liberman
authors.forename: D J
authors.initials: DJ
authors.lastname: Lee
authors.forename: M M
authors.initials: MM
authors.lastname: Goldsmith
authors.forename: J C
authors.initials: JC
authors.lastname: Price
mesh_terms: D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D011879:Radiotherapy Dosage; D013524:Surgical Flaps / Q000009:adverse effects; D015996:Survival Rate
chemical_list: D007457:Iodine Radioisotopes