Abstract
Low-dose-rate interstitial brachytherapy (LDRIB) represents an effective modality for treatment of oropharyngeal carcinoma. The drawback is radioexposure of medical personnel. To eliminate this concern, we initiated high-dose-rate interstitial brachytherapy (HDRIB) in 1993. The present study evaluated the efficacy and complications associated with this approach. Between 1993 and 2003, HDRIB +/- external radiotherapy was used to treat 83 oropharyngeal squamous cell carcinomas. Median duration of follow-up was 26 months (range, 1-108 months). Of the 82 patients, 76 were previously untreated and 6 displayed previous history of head and neck cancer. T distribution comprised T1 (n = 7), T2 (n = 47), T3 (n = 24), and T4a (n = 5). External radiotherapy of 46 Gy was combined with 21 Gy/3.5 fractions/2 days HDRIB for 68 lesions, and 48 Gy/8 fractions/5 days HDRIB alone was used for 15 lesions. Involved nodes were either boosted by external radiotherapy or resected. Five-year local control, regional control, cause-specific and overall survival rates were 82%, 84%, 88%, and 64%, respectively. Local control rates for early (T1/T2) and advanced (T3/T4) tumors were 89% and 66%, respectively (p = 0.02). Transient soft tissue necrosis was expe...Continue Reading
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