Interstitial HDR brachytherapy for advanced recurrent squamous cell carcinoma of the head and neck.

Background: Surgical treatment remains the mainstay therapy for recurrence of head and neck cancer after previous radiotherapy. In inoperable cases, interstitial high-dose rate brachytherapy is a treatment option for local dose escalation.

Patients And Methods: A retrospective analysis of all patients who were treated solely with brachytherapy for advanced non-resectable recurrences of squamous cell carcinomas of the head and neck and who previously received radiotherapy was performed.

Results: A total of 12 patients with advanced recurrences were treated with interstitial brachytherapy with a fraction dose of 2-3 Gy and a total focal dose of 20-33 Gy. The shortest survival after brachytherapy was 4 weeks. The longest clinical course without evidence of local recurrence is 4 years and 11 months.

Conclusion: In selected cases brachytherapy can be used as the last-line or palliative therapy for patients with advanced recurrence head and neck carcinomas. Possible complications and the reduction of quality of life due to tracheostomy should be considered.