title: Age is not a limiting factor for brachytherapy for carcinoma of the node negative oral tongue in patients aged eighty or older.
abstract: BACKGROUND
  To examine the role of brachytherapy for aged patients 80 or more in the trend of rapidly increasing number.
  
  
  METHODS
  We examined the outcomes for elderly patients with node negative oral tongue cancer (T1-3N0M0) treated with brachytherapy. The 21 patients (2 T1, 14 T2, and 5 T3 cases) ranged in age from 80 to 89 years (median 81), and their cancer was pathologically confirmed. All patients underwent definitive radiation therapy, with low dose rate (LDR) Ra-226 brachytherapy (n = 4; median 70Gy), with Ir-192 (n = 12; 70Gy), with Au-198 (n = 1) or with high dose rate (HDR) Ir-192 brachytherapy (n = 4; 60 Gy). Eight patients also underwent external radiotherapy (median 30 Gy). The period of observation ranged from 13 months to 14 years (median 2.5 years). We selected 226 population matched younger counterpart from our medical chart.
  
  
  RESULTS
  Definitive radiation therapy was completed for all 21 patients (100%), and acute grade 2-3 mucositis related to the therapy was tolerable. Local control (initial complete response) was attained in 19 of 21 patients (90%). The 2-year and 5-year local control rates were 91%, (100% for T1, 83% for T2 and 80% for T3 tumors after 2 years). These figures was not inferior to that of younger counterpart (82% at 5-year, n.s.). The cause-specific survival rate was 83% and the regional control rate 84% at the 2-years follow-up. However, 12 patients died because of intercurrent diseases or senility, resulting in overall survival rates of 55% at 2 years and 34% at 5 years.
  
  
  CONCLUSIONS
  Age is not a limiting factor for brachytherapy for appropriately selected elderly patients, and brachytherapy achieved good local control with acceptable morbidity.
authors.affiliation: Department of Radiology, Kyoto Prefectural University of Medicine, 465 Kajiicho Kawaramachi Hirokoji, Kamigyo-ku, Kyoto 602-8566 Japan. hideya10@hotmail.com
authors.forename: Hideya
authors.initials: H
authors.lastname: Yamazaki
authors.forename: Ken
authors.initials: K
authors.lastname: Yoshida
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Kotsuma
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Yoshioka
authors.forename: Masahiko
authors.initials: M
authors.lastname: Koizumi
authors.forename: Souhei
authors.initials: S
authors.lastname: Furukawa
authors.forename: Naoya
authors.initials: N
authors.lastname: Kakimoto
authors.forename: Kimishige
authors.initials: K
authors.lastname: Shimizutani
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D014062:Tongue Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D055815:Young Adult