Postoperative 125I brachytherapy delivered by digital model obturators for recurrent or locally advanced maxillary cancers

Objectives/Hypothesis: We aimed to evaluate the feasibility and effectiveness of postoperative 125I brachytherapy delivered by use of digital model obturators for recurrent or locally advanced maxillary cancers. Study Design: Retrospective study. Methods: From 2006 to 2008, 12 patients (seven females; median age, 65 years; range, 2286 years) with recurrent or locally advanced maxillary cancers showing positive margins after surgery underwent 125I brachytherapy by use of digital model obturators and interstitial implants. The radioactivity was 18.5 to 33.3 MBq per seed, and the prescription dose was 80 to 160 Gy. Functional outcome of patients was evaluated by the Performance Status Scale (PSS) for head and neck cancer before and after brachytherapy. Results: The 125I seeds and dosages were well distributed in the radiation fields, and all patients had higher PSS scores after than before treatment with obturators. During a median follow-up of 53 months (range, 2862 months), local control at 3 and 5 years was 83.3% and 66.7%, respectively, with a mean local control time of 53.5 +/- 3.79 months. Overall survival at 3 and 5 years was 91.7% and 71.4%, respectively, with a mean survival time of 56.6 +/- 2.99 months. Two patients died due to local recurrence, and one patient died due to lung metastasis. No patient had severe complications during follow-up. Conclusions: 125I brachytherapy delivered by digital model obturator is effective in treating maxillary cancers with positive margins after maxillectomy for advanced or recurrent cancer. The method may improve the quality of life of patients with maxillary defects. Laryngoscope, 2012Medicine, Research & ExperimentalOtorhinolaryngologySCI(E)PubMed1ARTICLE112461-246712