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.