Interstitial iridium-192 implantation for recurrent and/or locally advanced head and neck cancer

We report our experience with the use of interstitial iridium-192 implantat ion in the management of patients with recurrent and locally advanced squam ous cell carcinoma of the head and neck. Between June 1992 and July 1998 th is technique was employed in the management of two groups of patients: (1) a primary group, comprising 42 patients who had presented for the first tim e with advanced head and neck disease, and had therefore not undergone any previous treatment; and (2) a salvage group of 16 patients with recurrent d isease previously treated with external beam radiotherapy (four received th erapy to the neck, one to the cheek, eight to the tongue and three to the f loor of the mouth). The follow-up in each group was short, ranging from 3 t o 56 months. The overall response in the primary group was 38/42 (90%). A c omplete response was achieved in 35/42 (83%). In the salvage group, the ove rall response was 13/16 (81%); 4/16 (25%) showed a complete response and 9/ 16 (56%) a partial response. The estimated percentage surviving at 1 year f or patients with primary disease is 70% (95% confidence interval (CI) 54-86 ). For those receiving salvage therapy the estimated percentage surviving a t 1 year is 45% (95% CI 19-71).