BRACHYTHERAPY IN PATIENTS WITH NASOPHARYNGEAL CARCINOMA FOLLOWING EXTERNAL RADIOTHERAPY

Between September 1994 and 1996, 71 patients (51 males, 20 females) with the diagnosis of nasopharyngeal carcinoma were treated with either external beam radiation therapy (XRT) and brachytherapy (Group A) or external beam radiation therapy alone (Group B) at our department. The median age for whole group was 43 (Range:9-82). There were 1, 6, 12 and 52 patients in Stage I, II, III and IV, respectively. There were 8 patients with T1, 20 with T2, 23 with T3 and 20 with T4 tumors. External radiotherapy doses ranged between 5900-7070 cGy (Median: 6600 cGy). High dose rate (HDR) brachytherapy with an Ir-192 microSelectron afterloading unit was delivered in 39 patients at the conclusion of XRT using a single-channel nasal applicator. Dose was prescribed at 1 cm from the source and total dose of 12 Gy in 3 fractions in 3 consecutive days was given immediately following XRT. Mean follow-up time is 16.3 months. Local control was achieved in all patients in Group A. Three patients failed locally in Group B. Transient nasal obstruction was observed in 20/39 (%51) of patients treated with brachytherapy. A patient experienced synechy of the mucosal linings of the nose 6 months after and was treated with surgery. No severe complication attributed to brachytherapy was detected. The use of brachytherapy after external beam radiotherapy seems to improve local control without serious morbidity.