[Salvage therapy of advanced squamous cell carcinoma of the mouth cavity and oropharynx. Results of interstitial high-dose-rate brachytherapy combined with ablative tumor surgery].
OBJECTIVE
The clinical effect of high-dose-rate (HDR) interstitial brachytherapy combined with tumor resection was investigated in this retrospective study on patients with recurrent oral and oropharyngeal squamous cell carcinoma.


METHODS
Oral and oropharyngeal squamous cell carcinoma in 38 patients were treated over a period of 7 years (1988-1994) by HDR interstitial brachytherapy using Gammamed 12i equipment. Pretreatment of patients in terms of irradiation and surgery differed (33 irradiated with a total dose between 60.0 and 75.6 Gy, including 8 patients with additional surgery; 1 patient with surgery alone, and 4 patients without any pretreatment). Indications for interstitial brachytherapy differed according to individual responses to treatment and medical histories.


RESULTS
Interstitial brachytherapy was successful in the majority of patients, i.e. complete remission: 12, partial remission: 19, no change: 2, progression: 5. Local control and overall survival including patients with surgical treatment was 59% and 81% at 6 months and 47% and 49% after 12 months, respectively.


CONCLUSIONS
Interstitial HDR brachytherapy with Iridium 192 is recommended in patients with local recurrences or second primary carcinomas after previous external radiotherapy in the head and neck region. Combination of interstitial brachytherapy and surgery is preferable for these patients.
Friedrich
R E
RE
Klinik für Mund-, Kiefer- und Gesichtschirurgie, Nordwestdeutsche Kieferklinik, Universitätskrankenhaus Eppendorf, Universität Hamburg.
Krüll
A
A
Schwarz
R
R
Thurmann
H
H
Plambeck
K
K
Schmelzle
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007496:Iridium Radioisotopes / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery* / Q000628:therapy*; D009364:Neoplasm Recurrence, Local; D016609:Neoplasms, Second Primary / Q000532:radiotherapy* / Q000601:surgery*; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016879:Salvage Therapy; D013997:Time Factors
D007496:Iridium Radioisotopes