[Palliative HDR and PDR brachytherapy in treatment of head and neck cancer relapses].

The preliminary results of palliative HDR and PDR brachytherapy in head and cancer relapses were presented. 47 patients with locoregional recurrenceses were treated by means of HDR and PDR brachytherapy between 05.06.2001 and 31.12.2002 in Great Poland Cancer Center and ENT Dept. K. Marcinkowski University of Medical Sciences. All patients were rejected from salvage surgery or distant field irradiation because of tumor advancement and previous treatment. The mean time of the recurrence after the diagnosing of the disease and first treatment was 9, 7 month. 34 patients were treated by the means of the HDR brachytherapy with the 5 doses of 4 Gy per fraction, 13 patients were treated by the means of the PDR brachytherapy with the one stage treatment (9 doses) or two stage treatment (4 doses) with total dose ranged between 20-40 Gy. The remission after 1, 3, 6 months after treatment and early complications were assessed. In 7 (15%) patients complete remission (CR), in 31 (65.9%) partial remission (PR) and in 5 (10.6) no response for the brachytherapy (NR) were stated; in the other 4 (8.5%) patients there were progression of the tumor. Percentages of remission after 3 and 6 months were as follows: CR - 5 (10.6%) and 3 (6.4%), PR - 25 (53.2%) and 17 (36.2%), NR and Progr - 17 (36.2%) and 27 (57.4)%. In 35 (74.5%) cases superficial necrosis was observed in 6 month time. The both methods had similar percentages of side effects. HDR or PDR brachytherapy are effective method of palliative treatment in head and neck cancer relapses. Early complications are frequent and demands intensive pharmacological treatment.