Metronidazole and interstitial implantation in the treatment of extensive recurrent head and neck cancers

Abstract

Twenty‐three patients with recurrent or persistent epidermoid carcinoma of the oral cavity, all of whom had failed primary antitumor therapy, were treated with interstitial irradiation and a radiosensitizer. Such primary therapy had included radical surgery, external radiation therapy, or a combination of both. All patients underwent afterloading interstitial iridium‐192 implants. Each subject received 6 g/m2 metronidazole administered orally in one dose every 48 hours for the duration of the implant. The radiation dose ranged between 4500 and 6500 rads in 65 to 120 hours. Sixteen of 23 patients (69.6%) demonstrated complete regression of local disease, usually within 12 weeks. Ten of the 23 individuals (43%) remain alive and disease‐free with an average follow‐up of 25 months since the completion of the regimen. Neurologic and hepatic toxicity were notably absent. Nausea, mild diarrhea and accentuation of the radiation‐induced mucositis constituted the principal side effects. Copyright © 1981 American Cancer Society