D. Donath et al., THE POTENTIAL USES OF HIGH-DOSE-RATE BRACHYTHERAPY IN PATIENTS WITH HEAD AND NECK-CANCER, European archives of oto-rhino-laryngology, 252(6), 1995, pp. 321-324
Brachytherapy has proven to be an extremely valuable method of treatme
nt for head and neck cancer. The data supporting its application, howe
ver, is based on continuous low-dose-rate brachytherapy. To benefit fr
om improved radiation protection, outpatient treatments, and increased
patient tolerance of treatment set-up over that encountered in conven
tional low-dose-rate manually afterloaded brachytherapy, we implemente
d a high-dose-rate remote afterloading approach in selected patients w
ith head and neck cancers. This treatment was utilized in two differen
t roles in managing 29 patients. In its first role, it was used as the
sole treatment in 13 patients with T1-2 NO malignancies. A total of t
en treatments of 450-500 cGy each were delivered twice a day with a mi
nimum of 5-6 h between treatments. With a median follow-up of 9 months
, only 1 patient failed locally. In a second role, brachytherapy was a
pplied in a post-operative adjuvant setting following wide local excis
ion of tumors in patients who presented with recurrent disease (12 cas
es) or a second primary in the head and neck (4 cases). All patients h
ad previously received external irradiation to the head and neck. Due
to this previous course of irradiation, only eight treatments of 300 c
Gy each were delivered, for a total of 2400 cGy over a period of 4 day
s. However, with a follow-up of 2-16 months, only 3 patients remain di
sease free.