125I seed implantation as a surgical adjuvant in head and neck cancers

Between 1975 and 1980, 90 125I seed intra-operative interstitial implants were performed in 72 patients at the Stanford Medical Center. Twenty four patients had untreated stage III and IV neoplasms, while 43 patients with apparently unifocal head and neck post-irradiation recurrences received implants with curative intent. Another 5 patients with multiple head and neck recurrences were implanted palliatively. Local control in the implant volume was 75% for previously untreated patients and 56% for those with localized post-irradiation recurrences. The complications resulting from these implant procedures, the over-all head and neck local control rates and patient survival data are also tabulated. We conclude that intra-operative permanent 125I seed interstitial head and neck implants are feasible not only in patients with massive neoplasms, but also in those with involved surgical margins and when vital non-resectable adjacent structures are invaded. (orig.)