Permanent Iodine-125 implants in head and neck cancer

One hundred twenty-four patients were treated with advanced recurrent head and neck cancer for palliation with radioactive permanent Iodine-125 (125I) implants. Complete regression occurred in 71% of the 118 lesions for which evaluation was possible and greater than 50% regression occurred in 18%; no meaningful regression occurred in 11%. Local recurrence of cancer was subsequently seen in 21% of the lesions which had regressed completely, in 55% of those which had regressed incompletely, and in 100% of those which had not regressed. The incidence of serious complications was 5.5%. Overall, in 64% of the instances the implanted lesions remained controlled until the patient's death, usually due to progression of cancer elsewhere in the body. It is concluded that permanent 125I implants offer useful palliation to the patient with recurrent head and neck cancer with a minimum of toxicity and inconvenience. Because of their low toxicity even after prior full-course external radiation therapy, the authors are currently investigating their use as planned adjunct to external radiation therapy and chemotherapy in the initial definitive management of patients with locally advanced head and neck cancer.