title: Treatment outcome of high-dose-rate interstitial radiation therapy for patients with stage I and II mobile tongue cancer.
abstract: OBJECTIVE
  The aim of the study was to investigate the outcomes of high-dose-rate interstitial radiation therapy for patients with Stage I and II mobile tongue cancer retrospectively.
  
  
  METHODS
  Sixty-seven patients with Stage I and II mobile tongue cancer were treated with high-dose-rate interstitial radiation therapy, with or without external beam radiation therapy, between 1997 and 2007. The median dose of interstitial radiation therapy was 50 Gy in 10 fractions over 6 days. Thirty-five patients received external beam radiation therapy before interstitial radiation therapy. The median dose of external beam radiation therapy was 20 Gy delivered with single-lateral or bilateral fields, including the primary tumor site and upper jugular lymph nodes. Thirty-seven patients received concurrent chemotherapy, including carboplatin, cisplatin, fluorouracil or tegafur, gimeracil and oteracil (TS-1) systemically or with intra-arterial injection. Thirty-three patients received intratumoral injection of bleomycin before catheter insertion. The median follow-up time was 58.6 months (range 15.1-102.4 months).
  
  
  RESULTS
  The 5-year overall, cause-specific, progression-free survival rate and local control rate were 88.7, 92.1, 76.0 and 94.0%, respectively. Fourteen patients developed cervical lymph node recurrence, 11 of which were distributed within the external beam radiation therapy field. We found local failures in four cases within 2 years after the treatment and in three cases after >7 years, even though the latter were difficult to distinguish from second primary cancers.
  
  
  CONCLUSIONS
  The treatment results of our institutions were equivalent to previous reports. Most cervical lymph node metastases occurred within the external beam radiation therapy field, which implied that the external beam radiation therapy dose of 20-30 Gy was insufficient to prevent late cervical lymph node metastases.
authors.affiliation: *Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. shioyama@radiol.med.kyushu-u.ac.jp.
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsumoto
authors.forename: Tomonari
authors.initials: T
authors.lastname: Sasaki
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Shioyama
authors.forename: Katsumasa
authors.initials: K
authors.lastname: Nakamura
authors.forename: Kazushige
authors.initials: K
authors.lastname: Atsumi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nonoshita
authors.forename: Saiji
authors.initials: S
authors.lastname: Ooga
authors.forename: Tadamasa
authors.initials: T
authors.lastname: Yoshitake
authors.forename: Satoru
authors.initials: S
authors.lastname: Uehara
authors.forename: Hideki
authors.initials: H
authors.lastname: Hirata
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D001918:Brachytherapy / Q000009:adverse effects / Q000379:methods; D016190:Carboplatin / Q000008:administration & dosage; D059248:Chemoradiotherapy / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D007269:Injections, Intra-Arterial; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010094:Oxonic Acid / Q000008:administration & dosage; D011725:Pyridines / Q000008:administration & dosage; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D005641:Tegafur / Q000008:administration & dosage; D014062:Tongue Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy*; D016896:Treatment Outcome
chemical_list: D011725:Pyridines; D001761:Bleomycin; D005641:Tegafur; D010094:Oxonic Acid; D016190:Carboplatin; D002945:Cisplatin; D005472:Fluorouracil; C104201:gimeracil
keywords: interstitial radiation therapy; lymph node metastasis; tongue cancer