[Combined external and interstitial radiotherapy of vocal cord carcinoma]

Since 1984 an Ir-192 source with a high dose rate has been used for interstitial implants, and since 1986 in the treatment of the tumor-bearing vocal cord in the organ-preserving management of larynx carcinoma. The combined percutaneous and interstitial treatment has been administered either as the primary treatment or after incomplete removal of the tumour. So fat 16 patients have been treated, two of them presented with tumours on both cords. All patients refused radical surgical interventions, four of them refused cord stripping too. The treatment method included external radiotherapy with a dose of 4600 to 5000 cGy to the larynx. One to two weeks after external XRT an interstitial implant into the vocal cord followed. Using two needles per cord, a boost dose of 1000 cGy was given to the tumour area. The median follow-up time is 21.3 months (range five to 49, calculated October 1990). So far no local or regional failures occurred. None of the patients had intra- or postoperative complications. All patients have preserved their voice. No severe late effects could be observed. The number of patients is very low, but the preservation of voice is high psychosocial value.