title: Brachytherapy of neck metastases.
abstract: Brachytherapy with iridium 192 was used in 20 patients with recurrent or persistent neck metastases from a primary head and neck carcinoma. Nine patients had intra-operative brachytherapy in combination with a neck dissection. Three patients had an implant as a boost following external beam radiotherapy. Eight patients were treated by brachytherapy alone for unresectable neck recurrence ranging from 5 to 10 cm in diameter. Nineteen patients were evaluable for neck control: 15 patients had complete clearance of tumor and 13 patients were controlled at time of death or last follow-up. There were few complications from treatment. Five patients are alive at 5, 14, 16, 22, and 27 months post-implant with two patients having developed a second primary. Seven patients died from distant metastases, four from regional disease and four from intercurrent illness. Indications are summarized for this frequently forgotten but useful last option for patients with persistent or recurrent neck metastases.
authors.affiliation: Department of Radiation Oncology, Ottawa Regional Cancer Centre, Ontario, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Choo
authors.forename: L
authors.initials: L
authors.lastname: Grimard
authors.forename: B
authors.initials: B
authors.lastname: Esche
authors.forename: J
authors.initials: J
authors.lastname: Crook
authors.forename: P
authors.initials: P
authors.lastname: Genest
authors.forename: P
authors.initials: P
authors.lastname: Odell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D002277:Carcinoma / Q000532:radiotherapy* / Q000556:secondary* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy* / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007430:Intraoperative Care; D007496:Iridium Radioisotopes / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010166:Palliative Care; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D007496:Iridium Radioisotopes