Percutaneous computed tomography/ultrasonography-guided permanent iodine-125 implantation as salvage therapy for recurrent squamous cell cancers of head and neck.
OBJECTIVE
To assess the feasibility, efficacy, and morbidity of permanent percutaneous 125I seed implantation under computed tomography (CT)/ultrasonography guidance for recurrent squamous cell carcinomas of head and neck.


METHODS
Twenty-five patients underwent 125I seed implantation under CT or ultrasonography guidance. Postoperative dosimetry was routinely performed for all the patients. The actuarial D90 of the implanted 125I seeds ranged from 90 Gy to 160 Gy (median: 130 Gy). The activity of 125I seed ranged from 0.35 mCi to 0.8 mCi (median: 0.6 mCi). The total number of seeds implanted ranged from 3 to 61 (median: 22). The follow-up period ranged from 3 to 40 months (median: 8 months).


RESULTS
The median local disease-free progression was 12 months (95% CI, 4.8-19.2), and the 1- and 2-year local tumor control rates were 48.7% and 39.9%, respectively. The 1- and 2-year survival rates were 42.5% and 28.3%, respectively (median: 11 months) (95% CI, 8.2-13.8). Of the 25 patients, 6 (24%) died of local recurrence and 5 (20%) died of metastases; 2 patients showed recurrences at 3 and 8 months after seed implantation and subsequently died of pneumonia. One patient died of heart disease. One developed ulceration with tumor progression. Blood vessel damage and neuropathy were not observed.


CONCLUSIONS
The high local tumor control rates, minimal invasion, and low morbidity suggest that percutaneous 125I seed implantation is a feasible and safe salvage for patients with recurrent squamous cell carcinomas of the head and neck.
Jiang
Yu-Liang
YL
Department of Radiation Oncology, Peking University Third Hospital, Beijing 100191, PR China.
Meng
Na
N
Wang
Jun-Jie
JJ
Ran
Wei-Qiang
WQ
Yuan
Hui-Shu
HS
Qu
Ang
A
Yang
Rui-Jie
RJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D007457:Iodine Radioisotopes / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000532:radiotherapy*; D015641:Radiography, Interventional; D016879:Salvage Therapy / Q000009:adverse effects / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D007457:Iodine Radioisotopes