Application of hyperthermia and brachytherapy in the treatment of recurrent head and neck and pelvic tumors

The challenge of controlling recurrent carcinomas that relapse after surgery and radiation therapy continues to be daunting, especially since response to chemotherapy is partial and short-lived even when dosage is pushed to tolerance levels. The authors report 37 cases (22 head and neck and 15 perineopelvic) treated with interstitial hyperthermia using BSD antennas that delivered two heating sessions (42.50 for 1 hour each), which preceded and followed the use of Ir-192 implants. A dose of 3,500-6,500 cGy was delivered, based on prior therapy, tumor burden, and tissue conditions. Complete regression occurred in 32% of case (12 of 37), with a further 41% (15 of 37) showing partial regression(>50% of presenting tumor volume). Complete response occurred in about two-thirds of cases that received doses exceeding 6,000 cGy. Of factors studies that may influence results - prior therapy, tumor burden, heating pattern, stage, performance status, and age tumor burden and radiation dose were found to be relevant