[Teletherapy versus teletherapy and "boost" brachytherapy in the treatment of base of tongue tumors: 5-year results].
OBJECTIVE
To study the importance of high-dose-rate (HDR) boost brachytherapy (BT) after percutaneous irradiation of base of tongue tumors.


METHODS
Between 1992 and 2000 seventy patients with biopsy proven carcinoma of the base of tongue were treated with primary radiation therapy. Fourty patients received a mean dose of 61 Gy (range, 50-72 Gy) external beam irradiation, and afterwards 30 patients were treated with a mean dose of 18 Gy (range, 12-30 Gy) boost HDR BT. Prognostic factors were analyzed in uni- and multivariate model.


RESULTS
At a median follow-up of 56 (16-108) months, boost BT increased the incidence of local tumor control (LTC) from 38% to 67% (p=0.0145). The 5-year probability of LTC was 60% vs. 36% (p=0.0188), the locoregional tumor control 52% vs. 34% (p=0.0753) and the overall survival (OS) 46% vs. 26% (p=0.0545), respectively, in favor of the boost group. Serious, grade 4 radiation toxicity occurred in 5% (2/40) and 13% (4/30) without or with boost treatment, respectively (p=0.2110). In multivariate analyses for LTC, tumor size (p=0.0042) and boost (p=0.0444), and for OS tumor size (p=0.0047) and nodal status (p=0.0163) had a significant effect.


CONCLUSIONS
Boost BT after teletherapy improves LTC significantly without considerable increase in the risk of side-effects.
Takácsi Nagy
Zoltán
Z
Országos Onkológiai Intézet, Budapest, 1122, Hungary. takacsi@oncol.hu
Oberna
Ferenc
F
Somogyi
András
A
Polgár
Csaba
C
Major
Tibor
T
Pólus
Károly
K
Fodor
János
J
Németh
György
G
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001918:Brachytherapy / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011867:Radioisotope Teletherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D016019:Survival Analysis; D014062:Tongue Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D016896:Treatment Outcome