Brachytherapie mit 192Iridium bei lokalen Rezidiven von Nasopharynxkarzinomen

Background: Local recurrence of nasopharyngeal carcinomas can be treated in different ways. One option is re-irradiation e.g. as stereotactically guided convergent beam. An operative approach is possible in small recurrent tumours. Brachytherapy is a good alternative because of the steep dose gradient in the pre-irradiated area. Methods: First step is the creation of a wide approach to the nasopharynx. This leads to a tumour mass reduction and gives space for the applicator. The radioactive substance will be brought into contact with the tumour by an afterloading procedure. The advantage of this therapy is the possibility to protect the surrounding tissue whereas the tumour receives a relatively high dosage. Between 2/90 and 12/96 10 men and 3 women were treated according to this protocol. Results: The median age was 56 years (37-66 years), the average follow-up period was 49,7 months (8-123 months). 2 non keratinising and 11 undifferentiated carcinomas were treated. 5 of 13 patients were still alive at the end of the follow-up period. The 5 year over all survival rate was 46%. 3 patients are free of disease for 5 years or longer. The patients were treated 2 to 6 times with 7 Gy in 5 mm depth. Conclusions: The results show that good palliation can be achieved by the applied method but larger studies are required to give a definite statement.