Brachytherapy for recurrent head and neck cancer

Locoregional failure remains the predominant site of recurrence and cause o f death in patients with head and neck cancers. When a recurrence is too ex tensive for cure with surgery or radiotherapy alone, the curative role of r eirradiation (either alone or in combination with surgery) is not widely ap preciated because of concerns about the tolerance of tissues to reirradiati on. A radiation dose of at least 60 Gy is needed and should preferably (at least in part) be given using brachytherapy, a mode of radiotherapy involvi ng the intersititial or intracavitary implantation of radioactive sources i nto tumors. The results of brachytherapy, in particular for recurrent nasop haryngeal carcinoma and in nodal recurrences, are highlighted.