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


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.


CONCLUSIONS
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.
Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. drbhalavat@hotmail.com
Rajendra I
RI
Bhalavat
Umesh M
UM
Mahantshetty
Sanjay
S
Tole
Swamidas V
SV
Jamema
D000328:Adult; D000368:Aged; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010025:Osteoradionecrosis / Q000209:etiology; D011832:Radiation Injuries / Q000209:etiology; D011879:Radiotherapy Dosage; D013997:Time Factors; D014062:Tongue Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D017211:Treatment Failure; D016896:Treatment Outcome