Single-fraction image-guided high-dose-rate brachytherapy for head and neck cancer: three cases of palliative brachytherapy

PURPOSE: To present a small series of cases, in which single-fraction image-guided high-dose-rate (HDR) brachytherapy was provided as palliative treatment for inoperable head and neck cancer cases. MATERIAL AND METHODS: We used this technique to treat 3 patients with symptomatic head and neck cancer (tongue cancer, gingival metastasis of osteosarcoma, and external auditory canal cancer), who were not eligible for a definitive treatment. The purpose of palliative brachytherapy in all 3 patients was the relief of symptoms such as difficulty in eating, talking, and hearing. All patients were treated with computed tomography (CT) image-guided interstitial HDR brachytherapy under local anesthesia in an outpatient setting, with a single dose of 10 Gy. RESULTS: Satisfactory palliative effects were achieved in all cases without serious side effects. The palliative effects were sustained in 2 patients until death, and 1 patient lived for 39 weeks before a relapse. CONCLUSIONS: Our palliative treatment technique appears to be safe, effective, and less invasive, and could be a treatment option for symptomatic patients with head and neck cancer.