The impact of temporary iodine-125 interstitial implant boost in the primary management of squamous cell carcinoma of the oropharynx

✍ Scribed by Eric M. Horwitz; Arthur J. Frazier; Frank A. Vicini; Daniel H. Clarke; Gregory K. Edmundson; Richard D. Keidan; Gary S. Gustafson; Carl F. Dmuchoswki; Alvaro A. Martinez

• Publisher: John Wiley and Sons
• Year: 1997
• Tongue: English
• Weight: 261 KB
• Volume: 19
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/(sici)1097-0347(199705)19:3<219::aid-hed10>3.0.co;2-6

✦ Synopsis

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.