Brachytherapy for recurrent head and neck cancer

Locoregional failure remains the predominant site of recurrence and cause of death in patients with head and neck cancers. When a recurrence is too extensive for cure with surgery or radiotherapy alone, the curative role of reirradiation (either alone or in combination with surgery) is not widely appreciated because of concerns about the tolerance of tissues to reirradiation. A radiation dose of at least 60 Gy is needed and should preferably (at least in part) be given using brachytherapy, a mode of radiotherapy involving the intersititial or intracavitary implantation of radioactive sources into tumors. The results of brachytherapy, in particular for recurrent nasopharyngeal carcinoma and in nodal recurrences, are highlighted.