[Results of temporary interstitial iridium 192 implantation in head and neck tumors]

In order to improve local tumor control in advanced head and neck tumors, a temporary interstitial iridium-192 implantation (40 to 50 cGy/h) was performed as a boost therapy (20 to 30 Gy at the surface of the target volume). This treatment was part of a multimodal therapy conception for primary tumors (N = 55) as well as for recurrences (N = 22). Local control was achieved in 89% (49/55) of patients treated for primary tumors. Complications appeared in the form of soft tissue necroses in 55% (30/55) and in the form of osteoradionecrosis of the mandible in 7% (4/55) of the patients. The authors discuss as possible reasons for this high complication rate: implantation volume too large or total activity too high, activities of the individual iridium-192 seeds to high, setting of radiation sources too close together, total dose too high, disturbed reparation capacity of sound tissues due to preceding operation and chemotherapy, premature test biopsies in the area of implantation, lacking oral hygiene and dental care by uncooperative patients. A local control rate of 50% was achieved by the treatment of recurrences, but this has no importance for the course of this tumor disease which is fatefully determined by the formation of remote metastases.