[Short- to mid-term evaluation of CT-guided 125I brachytherapy on recurrent or metastatic head and neck cancers].

OBJECTIVE

to evaluate the short- and medium-term clinical effects of 125I seed implantation on recurrent or metastatic head and neck cancers.

METHODS

Thirty patients with recurrent or metastatic head and neck cancers after operation, radiotherapy, or chemotherapy, totaling 421 lesions 4.2 (2-9) cm in diameter, 23 males and 12 females, aged 56 (39-71), underwent implantation of 12-70 125I seeds (on average 33 per person) under the guidance of CT, ultrasonography, or endoscopy with an interval of 1 cm between any 2 seeds with the radioactive activity per seed of 29.6 MBq and matched peripheral dose of 90-160 Gy. Follow-up was conducted for 13 (4-40) months to observe the local control rate, overall survival rate, pain relief, and clinical complications.

RESULTS

Follow-up 4 months later showed that 24 of the 42 lesions obtained complete remission, 11 obtained partial remission, 5 no change, and 2 progress of disease, with a clinical response rate of 83.3% (CR+PR). The overall 1-, 2-, and 3-year survival rates were 88.4%, 72.4%, and 45.2% respectively with a median survival time of 31 months. The pain relief rate was 73.4% (17/23). The long-term complications included hyperpigmentation at operative sites (n=4), insensible feeling on lateral cheek (n=3), dryness of oral cavity (n=2), and headache combined with infection (n=1).

CONCLUSIONS

Relieving the pain, improving the life quality, CT guided radioactive 125I seed implantation is a simple, safe, and effective method in treating recurrent or metastatic head and neck cancer with minimal damage and few complications.