Yh. Son et Ct. Sasaki, NONSURGICAL ALTERNATIVE THERAPY FOR BULKY ADVANCED HEAD AND NECK TUMORS, Archives of otolaryngology, head & neck surgery, 121(9), 1995, pp. 991-993
Objective: To rapidly induce symptomatic relief and local tumor contro
l in bulky advanced head and neck tumors without surgery. Design: A re
trospective analysis of the results with palladium 103-labeled or iodi
ne 125-labeled brachytherapy (BT) and adjunctive external beam radiati
on therapy (EBRT);a survival analysis by the Kaplan-Meier method; and
a comparison of results between the BT/EBRT and EBRT/BT (or BT alone)
groups by the log-rank test. A nonsurgical alternative therapy was giv
en to a total of 51 patients who presented with tumors of more than 10
0 cm(3) in volume. Results: Moderate to complete symptomatic relief wa
s observed in 31 (61%) of 51 patients. Seven (33%) of 21 patients in t
he BT/EBRT group and two (7%) of 30 in the EBRT/BT group were recurren
ce-free at 36 months. The difference was significant by the log-rank t
est. Cause-specific and overall 36-month survivals were 23% and 5%, re
spectively. Conclusion: Cure rate by conventional therapy in bulky adv
anced head and neck tumors is dismal. The palladium 103- or iodine 125
-BT/EBRT offers good symptomatic relief and an acceptable probability
of recurrence-free survival.