Brachytherapy for Head and Neck Cancer.
Brachytherapy is a useful addition to external beam irradiation in the treatment of patients with head and neck cancer. Removeable implants are especially important in the treatment of neoplasms of the oral cavity (tongue, floor of mouth, buccal mucosa), orophrynx (tonsil, palate, and base tongue) and nasopharynx (intracavitary boosts). The most commonly used isotope for removable implants is irdium 192. The remote afterloading technique is applicable to both interstitial and intracavitary removable implants. Permanent placement of iodine 125 and palladium 103 radioactive sources may be performed for recurrent nasophayngeal malignancies, for palliation of accessible recurrences of primary sites in the oral cavity, oropharynx, and hypopharynx, or for cervical lymph node metastases. With brachytherapy, high radiation doses may be delivered to the volume of interest, while at the same time protecting adjacent normal tissues. Such implantations, if carefully performed, are effective, safe, and have a low risk of complications.
Goffinet
DR
Department of Radiation Oncology, Stanford University, Stanford, CA, USA