Iridium 192 implantation of squamous cell carcinomas of the oropharynx

From 1970 to 1984, 127 patients with T1 or T2 carcinomas of the oropharynx were treated with external irradiation to the primary tumor and neck nodes to a dose of 45 Gy, followed by a further 30 Gy delivered by an iridium 192 implant to the primary tumor. Patients with clinically positive nodes had either further neck irradiation using electrons or a neck dissection. Crude 5-year disease-free survival was 66% for tonsillar carcinomas, 43% for soft palate, and 51% for base of tongue. Local control was 98%, 85%, and 76%, respectively. Regional control was 97% for N0 patients and 88% for N1-3. Soft tissue ulceration occurred in 17 patients; all healed spontaneously. The high rate of local control achieved in these patients while preserving function and minimizing xerostomia supports the use of this approach.