Brachytherapy boost: a novel approach for epiglottic carcinoma.
OBJECTIVE
Epiglottic (epilaryngeal) carcinoma has been treated conventionally by radical external beam radiotherapy or partial laryngectomy. The aim of this study is to evaluate the role of brachytherapy boost as a novel approach for lingual epiglottic lesions.


METHODS
Twenty-three patients with T(2-3)N(0-1) lingual epiglottic carcinoma (SCC) were treated with curative intent between January 1990 and December 2001 using low dose rate interstitial (192)Ir implant boost, moderate dose of 25Gy at 0.5cm (mean dose rate, 50.5 cGy/h) 3 weeks after moderate dose of external beam radiotherapy (mEBRT) of 46Gy/23#/28-31d.


RESULTS
Complete response after mEBRT was observed in 18 of the 23 patients (78%) and partial response was seen in 5 of the 23 patients (22%). After implant, all patients had complete response. Locoregional control was seen in 19 of the 23 patients (82.6%). Two patients developed distant metastases. Disease-free survival and overall survival at 5 years were 68.3% and 66.7%, respectively. Disease-free survival at 5 years showed a trend toward better outcome for biologically equivalent doses >85Gy compared with biologically equivalent doses <85Gy (80% vs. 68%) (p=0.18). All patients had minimal to acceptable xerostomia.


CONCLUSIONS
Interstitial boost with mEBRT is feasible, effective, and a novel approach for lingual epiglottic lesions.
Department of Radiation Oncology, Tata Memorial Hospital, Dr. Ernest Borges Road, Parel, Mumbai, India. drbhalavat@yahoo.com
Rajendra L
RL
Bhalavat
Kumar Alok
KA
Pathak
Umesh
U
Mahantshetty
Swamidas V
SV
Jamema
D001918:Brachytherapy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D018572:Disease-Free Survival; D004307:Dose-Response Relationship, Radiation; D004825:Epiglottis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome