title: Postoperative interstitial brachytherapy for resectable squamous cell carcinoma of the tongue.
abstract: OBJECTIVE
  To evaluate the efficiency and toxicity of postoperative brachytherapy (POBT) in the treatment of resectable mobile tongue squamous cell carcinoma.
  
  
  METHODS
  This was a retrospective single-center study of patients with SSC of the mobile tongue who were treated between August 1992 and June 2013 by glossectomy and neck dissection followed by (192)Ir interstitial brachytherapy of the tumor bed. Endpoints were local control, cancer-specific survival (CSS), overall survival (OS), and morbidity. Independent prognostic factors were analyzed in a Cox regression model.
  
  
  RESULTS
  A total of 112 patients were identified (median age, 55 years [range, 15-84]; 76% male). Patient and tumor characteristics were: T1T2N0 (85%), pN+ (13%), positive surgical margins (14%), negative margins <5 mm (29%), dysplasic margins (14%), lymphatic vessel invasion (5%), and perineural spread (5%). Median followup was 6.7 years (1.5 months to 17.7 years). Local control, CSS, and OS rates at 2 years were 79%, 81%, and 72%, respectively. The corresponding 5-year rates were 76%, 67%, and 56%, respectively. After POBT, 22% of patients presented grade ≥2 necrosis and 8% experienced chronic pain. Independent prognostic factors were positive surgical margins for poor local control and tumor recurrence and lymphatic vessel invasion for poor OS.
  
  
  CONCLUSIONS
  POBT provided good local control and better CSS and OS than reported for surgery alone. Morbidity was higher than that reported for brachytherapy alone but may be considered acceptable in a well-selected patient population at high risk of local recurrence.
authors.affiliation: Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, St Herblain, France. Electronic address: aurore.goineau@ico.unicancer.fr.
authors.forename: Aurore
authors.initials: A
authors.lastname: Goineau
authors.affiliation: Department of Maxillofacial Surgery, Hôtel-Dieu Hospital, University of Nantes, Nantes, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Piot
authors.affiliation: Head and Neck Department-Head and Neck Surgery, Hôtel-Dieu Hospital, University of Nantes, Nantes, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Malard
authors.affiliation: Head and Neck Department-Head and Neck Surgery, Hôtel-Dieu Hospital, University of Nantes, Nantes, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Ferron
authors.affiliation: Department of Radiophysics, Institut de Cancérologie de l'Ouest, St Herblain, France.
authors.forename: Albert
authors.initials: A
authors.lastname: Lisbona
authors.affiliation: Department of Pathology, Hôtel-Dieu Hospital, University of Nantes, Nantes, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Cassagnau
authors.affiliation: Department of Radiology, Hôtel-Dieu Hospital, University of Nantes, Nantes, France.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Delamazure
authors.affiliation: Biostatistics Unit, Institut de Cancérologie de l'Ouest, St Herblain, France.
authors.forename: Loïc
authors.initials: L
authors.lastname: Campion
authors.affiliation: Department of Radiation Oncology, Institut de Cancérologie de l'Ouest, St Herblain, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Bardet
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D011184:Postoperative Period; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D016896:Treatment Outcome
keywords: Postoperative brachytherapy; Prognosis factors; Tongue neoplasm