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.
Bhalavat
Rajendra I
RI
Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. drbhalavat@hotmail.com
Mahantshetty
Umesh M
UM
Tole
Sanjay
S
Jamema
Swamidas V
SV
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