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The impact of temporary iodine‐125 interstitial implant boost in the primary management of squamous cell carcinoma of the oropharynx
Author(s) -
Horwitz Eric M.,
Frazier Arthur J.,
Vicini Frank A.,
Clarke Daniel H.,
Edmundson Gregory K.,
Keidan Richard D.,
Gustafson Gary S.,
Dmuchoswki Carl F.,
Martinez Alvaro A.
Publication year - 1997
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/(sici)1097-0347(199705)19:3<219::aid-hed10>3.0.co;2-6
Subject(s) - medicine , osteoradionecrosis , implant , surgery , brachytherapy , radiation therapy , basal cell , tongue , pathology
Abstract Background To define the impact of interstitial boost of the oropharynx on local control and complications using iodine‐125 (I‐125) brachytherapy. Methods Between October 1986 and September 1991, 19 patients with cancer of the oropharynx received treatment at William Beaumont Hospital. Primary tumors consisted of 13 base of tongue, 4 tonsillar, and 2 pharyngeal wall lesions. All patients received 45–66 Gy (median, 54 Gy) external beam irradiation to the primary and regional nodes, followed by an interstitial implant of 22–32 Gy (median, 25 Gy) with I‐125. Results Median follow‐up was 58 months (range, 12–89 months.) Three patients failed within the tumor bed, for a 5‐year actuarial rate of local control of 83% (T1/T2, 82%; T3/T4, 86%). Two of the three local failures were salvaged surgically, for an overall 5‐year actuarial local control rate of 94%. The 5‐year actuarial overall survival rate was 64%. Complications included one case of soft tissue ulceration and two cases of osteoradionecrosis, all managed conservatively. Conclusions Patients with cancer of the oropharynx judged to be candidates for boosts with interstitial implants can be effectively treated with I‐125. Local control was excellent, and complications were minimal. © 1997 John Wiley & Sons, Inc. Head Neck 19: 219–226, 1997.