| Abstract: |
We reported the outcome of 117 radioactive neck implants performed on 100 patients with recurrent or locally advanced squamous cell carcinoma which was used as part of the management of their neck disease. Permanent iodine- 125 implants were performed in 84 cases (72%), and the remaining 33 cases (28%) were treated via a temporary implant. Most of these patients had received previous treatment to the neck, which included prior external beam radiotherapy, surgery, or both. Patients in group A received an implant for microscopic residual disease following a neck dissection. Group B were treated with an implant for gross residual tumor or unresectable disease. The actuarial neck control rates for groups A and B were 87% vs 58%, respectively, at 12 months and 43% vs 20%, respectively, at 24 months. The actuarial survival rates for groups A and B were 67% vs 38%, respectively, at 12 months and 32% vs 17%, respectively, at 24 months. Complications of the procedure were noted in seven patients (6%), which included three patients with carotid blowout who had received prior external beam irradiation and neck dissection without myocutaneous flap reconstruction. In conclusion, brachytherapy using temporary or permanent radioactive implantation to the neck for patients with gross residual disease after neck dissection is associated with inferior regional control. Control rates for patients treated with implantation for microscopic residual disease is better but still suboptimal. |
