Treatment outcome with low-dose-rate interstitial brachytherapy in early-stage oral tongue cancers.

Abstract

PURPOSE:

Although radical radiotherapy is known to be equally effective for early-stage oral tongue cancers (T1-2 N0) with the added advantage of organ and function preservation, surgery remains the preferred treatment. We present outcome of patients treated with brachytherapy (BT) either radical or boost.

MATERIALS AND METHODS:

Fifty-seven patients (T1/T2 31/26) were studied. Seventeen patients (30%) were treated with radical BT (50-67 Gy) while 40 (70%) with external beam radiation therapy (EBRT) + BT (36-56 Gy + 15-38 Gy]. Low-dose-rate (LDR) BT was delivered with 192 Ir wires, using plastic bead technique with varied dose rates (<60 cGy/h in 29 patients, 60-90 cGy/h in 17, and >90 cGy/h in 11).

RESULTS:

The overall local control (LCR) was achieved in 59.7% (34/57) patients. LCR for T1 and T2 was 67.8% and 50%, respectively. A total of 23 patients had failures [local: 20 (T1: 8; T2: 12 patients), node: 5 (T1:2; T2: 3), and local + nodal: 3]. Overall 5-year disease-free survival and overall survival (OAS) were 51% and 67%, respectively and those for T1 and T2 was 64.5/77.4% and 38.5/54% respectively (P = 0.002). All 16 patients were salvaged. Median survival after salvage treatment was 13.5 months (6-100 months). Soft tissue necrosis was observed in 12.3% (7/57) and osteoradionecrosis in two patients.

CONCLUSION:

BT, as an integral part of radical radiation therapy in early-stage tongue cancers, appears to be an effective alternative treatment modality with preservation of the organ and function without jeopardizing the outcome.

• Authors: Rajendra I Bhalavat, Umesh M Mahantshetty, Sanjay Tole, Swamidas V Jamema
• Journal: Journal of cancer research and therapeutics (J Cancer Res Ther) 2009 Jul-Sep Vol. 5 Issue 3 Pg. 192-7 ISSN: 1998-4138 [Electronic] India
• PMID: 19841561 (Publication Type: Journal Article)

Topics

• Adult
• Aged
• Brachytherapy (adverse effects, methods)
• Disease-Free Survival
• Dose-Response Relationship, Radiation
• Female
• Follow-Up Studies
• Humans
• India
• Male
• Middle Aged
• Neoplasm Staging
• Osteoradionecrosis (etiology)
• Radiation Injuries (etiology)
• Radiotherapy Dosage
• Time Factors
• Tongue Neoplasms (pathology, radiotherapy)
• Treatment Failure
• Treatment Outcome