Interstitial radiotherapy with Ir-192 as a palliative treatment modality in head and neck cancer.

In selected patients with advanced head and neck cancer interstitial radiotherapy with Ir-192 can be used as a palliative treatment. Using two cases as examples, we report on our experiences with 19 patients.

[Interstitial brachytherapy using 192-iridium in locally recurring tumors]. / Die interstitielle Brachytherapie mit 192Iridium bei lokal rezidivierenden Tumoren.

Between January 1983 and December 1985 49 patients with different malignancies underwent a palliative interstitial brachytherapy with 192Iridium. 25 patients with local recurrences without distant metastases were analysed retrospectively: 17 (68%) complete remissions and six (24%) partial remissions were achieved, two (8%) patients did not respond to therapy. Seven patients (28%) developed subsequent recurrence.

Radiotherapy of presacral recurrence following radical surgery for rectal carcinoma.

The records of 58 patients treated by radiotherapy for presacral recurrent rectal cancers between 1975 and 1982 were evaluated. Pain was one of the most distressing symptoms, occurring in 38 of 58 patients (66 percent) which, in 90 percent (34 of 38) of patients could be controlled by radiotherapy. Side effects were mild, and could be treated conservatively. The crude survival of the patients was 19.8 months (range, 3 to 71 months). Only 3 percent of those treated survived five years. The dose-survival study showed increased survival of patients treated with more than 44 Gy. Because of negative selection of patients irradiated with lower doses, certain conclusions cannot be made. Surgery, if performed radically, is the treatment of choice. But patients with inoperable disease treated with radiotherapy benefit symptomatically, and might have increased survivals with a small chance of cure.

[Radiotherapy of choroid metastases in breast carcinoma]. / Zur Strahlentherapie von Aderhautmetastasen bei Mammakarzinom.

From 1975 to 1984, thirteen patients were submitted to radiotherapy for choroid metastases of mammary carcinoma. Bilateral manifestation was found in three cases, thus sixteen eyes have been treated. All irradiations were performed with high voltage equipment. The posterior section of the eye was irradiated with 25 to 50 Gy over 2.5 to 5 weeks. Complete regression was achieved in nine out of sixteen cases, five patients showed an improvement of at least 50%, no considerable effect was found in two cases. The survival is 4 to 48 months (median survival 20 months) from the beginning of radiotherapy. Radiotherapy is a quick, efficient, and sparing treatment in choroid metastases. If applied in due time, it can prevent a visual disorder or amaurosis, thus improving the patients' quality of life.

The role of interstitial irradiation (brachytherapy) with iridium-192 in the treatment of head and neck cancers.

The value of interstitial radiotherapy (brachytherapy) in the treatment of malignant tumors of the head and neck is reported, with special regard to different methods of iridium-192 implantation. The advantages and disadvantages of these techniques are discussed. Results obtained in treating patients with oral cancers are presented.

[Radiotherapy of carcinoma of the paranasal sinuses]. / Strahlentherapie der Nasennebenhöhlenkarzinome.

Carcinomas of the paranasal sinuses are usually advanced when diagnosed and present a therapeutic challenge. During the period between February 1970 and June 1981 44 patients were treated. 22 received postoperative irradiation, seven in combination with chemotherapy. 18 patients were treated with radiation alone, eleven with concomitant chemotherapy. Four patients received preoperative irradiation, three in combination with chemotherapy. The three-year survival is 43% and the five-year survival 33%. For those 26 patients who were irradiated pre- or postoperatively with or without concomitant chemotherapy the five-year survival is 45%. We believe the patient will be afforded the greatest opportunity for cure with the combined efforts of the radiotherapist and the surgeon. The combination of chemotherapy and radiotherapy did not provide better results but increased acute and chronic toxicity of the therapy.