title: Limited external irradiation and interstitial 192iridium implant in the treatment of squamous cell carcinoma of the tonsillar region.
abstract: Between January 1976 and March 1982, 80 patients with histologically proven diagnosis of squamous cell carcinoma of the tonsillar region were treated with definitive radiotherapy. Sixty-five (81%) of these patients had locally advanced tumors (Stage III and IV); 49% of patients had clinically palpable cervical lymphadenopathy. All patients received a combined external megavoltage and interstitial irradiation. The dose of external irradiation was limited to 4500-5000 cGy over 41/2 to 51/2 weeks. This was followed by interstitial 192iridium implants to doses of 2000-2500 cGy in 50-60 hours for T1, T2 lesions and 3000-4000 cGy in 60-100 hours for T3 , T4 lesions. The neck masses were also separately implanted to deliver additional doses of 2000-4000 cGy in 50-80 hours. Overall local tumor control was observed in 84% of patients with a minimum follow-up period of 2 years. An absolute 3-year disease free survival of the entire group was 72%. Treatment related complications such as soft tissue necrosis or osteoradionecrosis occurred in 6% (5/80) of patients. The salvage of neck failures and local failures was possible in 78 and 38% of patients, respectively, either by surgery or by re-irradiation employing interstitial 192iridium implants. Functional and esthetic integrity was well preserved in most cases.
mesh_terms: D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000295:instrumentation; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D007495:Iridium / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010157:Palatal Neoplasms / Q000532:radiotherapy; D010160:Palate, Soft; D011868:Radioisotopes / Q000627:therapeutic use*; D011882:Radiotherapy, High-Energy; D014067:Tonsillar Neoplasms / Q000532:radiotherapy*
chemical_list: D011868:Radioisotopes; D007495:Iridium