Salvage brachytherapy of posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area.
OBJECTIVE
Brachytherapy performed in patients with posterior pharyngeal wall carcinoma in a previously irradiated area is evaluated in terms of local control, survival, and complications.


METHODS
Between January 1982 and July 1993, 14 patients were treated with interstitial low dose rate brachytherapy alone for posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area (local recurrences in five cases and second tumors in nine cases). Tumor size ranged from 1 to 4 cm. No patient had a macroscopic nodal involvement or metastase at the time of diagnosis. Median dose delivered was 55 Gy (39 to 60 Gy).


RESULTS
Thirteen patients were assessed for local control. Twelve of them achieved complete macroscopic response within 2 months after brachytherapy. Local relapse occurred in five patients, from 5 to 29 months after brachytherapy. One patient developed distant metastatis without loco-regional relapse. Disease free survival was 69, 59, and 37% at 1, 2, and 5 years, respectively; overall survival was 78, 50, and 21% at 1, 2, and 5 years, respectively. Three patients were still alive without recurrence (8, 8, and 10 years after treatment). We did not observe any severe acute or delayed toxicity.


CONCLUSIONS
Based on these results, interstitial brachytherapy should be considered as a potentially curative treatment for selected patients with posterior pharyngeal wall squamous cell carcinoma in a previously irradiated area. There are no reports in the literature on this subject.
Pommier
P
P
Department of Radiotherapy, Centre Léon Bérard, Lyon, France.
Bolot
G
G
Martel
I
I
Montbarbon
X
X
Ardiet
J M
JM
Coquart
R
R
Poupart
M
M
Leval
J
J
Ramade
A
A
Dubreuilh
C
C
Pignat
J C
JC
Carrie
C
C
D000368:Aged; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000532:radiotherapy*; D016609:Neoplasms, Second Primary / Q000473:pathology / Q000532:radiotherapy*; D010610:Pharyngeal Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D011879:Radiotherapy Dosage; D016879:Salvage Therapy / Q000379:methods*