Interstitial high dose rate brachytherapy in locally progressive or recurrent head and neck cancer

In a retrospective study, 19 patients with progressive or recurrent head an d neck cancer which had been treated with interstitial high dose rate brach ytherapy were analysed. All of them had been previously treated with extern a; radiation. Initial therapy further included surgery in 9 cases and chemo therapy in 3 patients. Staging according to the TNM system revealed advance d stage tumors in the majority of patients. Interstitial brachytherapy was carried out with the isotope Iridium-192. The applied total dose at the ref erence isodose varied between 10 and 30 Gy. Application was fractionated on ce a week. A complete tumor remission was achieved in 5 patients and partia l remission in 10 patients. In 4 patients the rumor continued to grow despi te brachytherapy. The mean follow-up in our collective was 21 months. The c alculated local control rate was 34% at 24 months. The survival rate was 49 % at 12 months and 35% at 24 months. Interstitial brachytherapy is recommen ded as a palliative treatment in preirradiated squamous cell carcinoma with local recurrence or progression.