SALVAGE TREATMENT FOR INOPERABLE NECK NODES IN HEAD AND NECK-CANCER USING COMBINED IR-192 BRACHYTHERAPY AND SURGICAL RECONSTRUCTION

The results of debulking surgery and re-irradiation with radioactive i mplants (brachytherapy) are reported for 39 patients with inoperable m etastatic neck nodes from primary head and neck cancers, For 13 patien ts conventional salvage by partial debulking surgery and brachytherapy proved effective, with 68 per cent control at 1 year, but six patient s suffered severe radiation fibrosis, necrosis and contractures. Some 26 patients were treated by combined tumour debulking, skin resurfacin g and brachytherapy implant. Initial tumour control and freedom from s erious toxicity was achieved in 24 patients. Local control was achieve d in 63 per cent of patients at 1 year, with a serious morbidity rate of 12 per cent.