Nonsurgical alternative therapy for bulky advanced head and neck tumors.
OBJECTIVE
To rapidly induce symptomatic relief and local tumor control in bulky advanced head and neck tumors without surgery.


METHODS
A retrospective analysis of the results with palladium 103-labeled or iodine 125-labeled brachytherapy (BT) and adjunctive external beam radiation therapy (EBRT); a survival analysis by the Kaplan-Meier method; and a comparison of results between the BT/EBRT and EBRT/BT (or BT alone) groups by the log-rank test. A nonsurgical alternative therapy was given to a total of 51 patients who presented with tumors of more than 100 cm3 in volume.


RESULTS
Moderate to complete symptomatic relief was observed in 31 (61%) of 51 patients. Seven (33%) of 21 patients in the BT/EBRT group and two (7%) of 30 in the EBRT/BT group were recurrence-free at 36 months. The difference was significant by the log-rank test. Cause-specific and overall 36-month survivals were 23% and 5%, respectively.


CONCLUSIONS
Cure rate by conventional therapy in bulky advanced head and neck tumors is dismal. The palladium 103- or iodine 125-BT/EBRT offers good symptomatic relief and an acceptable probability of recurrence-free survival.
Son
Y H
YH
Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, Conn., USA.
Sasaki
C T
CT
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010165:Palladium / Q000627:therapeutic use; D011868:Radioisotopes / Q000627:therapeutic use; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D007457:Iodine Radioisotopes; D011868:Radioisotopes; D010165:Palladium