Efficacy of brachytherapy concomitant with chemotherapy with docetaxel, cisplatin, and 5-fluorouracil in unresectable head and neck squamous cell carcinoma

Purpose: Brachytherapy is a form of targeted radiation therapy and has shown good short-term efficacy in clinical practice. The purpose of this clinical trial was to determine the feasibility and safety of radioactive iodine 125 seeds implantation concomitantly with chemotherapy with docetaxel, cisplatin, 5-fluorouracil (TPF) in patients with head and neck squamous cell carcinoma (HNSCC). Methods: A total of 23 previously untreated patients with histologically documented advanced unresectable HNSCC underwent percutaneous interstitial implantation of radioactive iodine 125 seeds, and simultaneously received 3 cycles of chemotherapy every 21 days (75 mg/m(2) docetaxel Dl, 75 mg/m(2) cisplatin Dl, and 750 mg/m(2) 5-fluorouracil D2-5). The treatment efficacy was evaluated based on tumor size and clinical symptoms of the patients. Results: The overall response rate was 78.3%. No acute complications and treatment -related radiation damages occurred. Two-year progression free survival (PFS) 60.9% and overall survival (OS) 52.2% were achieved. Four patients (17.4%) died of cardiovascular causes and local disease recurrence. Conclusion: Brachytherapy based on iodine 125 seeds implantation given concomitantly with chemotherapy is a mildly invasive, effective and safe therapeutic approach for advanced HNSCC.