title: CT-guided125I brachytherapy in the treatment of distant metastases in the oral cavity and maxillofacial region.
abstract: OBJECTIVE
  We aimed to evaluate the feasibility and clinical effectiveness of CT-guided125I brachytherapy for distant oral and maxillofacial metastases.
  
  
  METHODS
  We retrospectively analyzed 65 patients with 84 distant oral and maxillofacial metastases. Thirty-one patients with 38 lesions received125I brachytherapy (group A) and 34 with 46 lesions received external beam radiotherapy (EBRT; group B).
  
  
  RESULTS
  Median follow-up time was 16 months. The 3-, 6-, 12-, 18-, and 24-month local control rates for group A were 83.9%, 75.9%, 66.7%, 38.4%, and 25.0%, respectively; for group B they were 76.5%, 62.5%, 43.8%, 25.0%, and 0.0%, respectively (P<.05); the median local tumor progression-free survival times were 14 and 9 months, respectively. Group A had a better local tumor progression-free survival (LTPFS) relative to group B (P<.001; HR, 6.961 [95%CI, 2.109, 9.356]). Cox proportional hazards regression analysis indicated that125I brachytherapy, tumor size, and primary pathological type were the independent factors affecting LTPFS. Additionally,125I brachytherapy showed better performance in relieving patient clinical symptoms relative to EBRT (P<.05). Group A also had fewer complications than group B, especially regarding grade 3/4 complications according to Radiation Therapy Oncology Group grading criteria. Mean overall survival times in groups A and B were 17.1 and 14.8 months, respectively.
  
  
  CONCLUSIONS
  CT-guided125I brachytherapy is feasible and safe for distant oral and maxillofacial metastases; it achieved a better local control rate, longer LTPFS and fewer complications without compromising overall survival compared with EBRT.
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China.. Electronic address: yanhzh@sysucc.org.cn.
authors.forename: Huzheng
authors.initials: H
authors.lastname: Yan
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China.. Electronic address: xiangzhw@sysucc.org.cn.
authors.forename: Zhanwang
authors.initials: Z
authors.lastname: Xiang
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China.. Electronic address: zhongzhh@sysucc.org.cn.
authors.forename: Zhihui
authors.initials: Z
authors.lastname: Zhong
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China.. Electronic address: mozhq@sysucc.org.cn.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Mo
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China.. Electronic address: zhangtao@sysucc.org.cn.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China.. Electronic address: chengy@sysucc.org.cn.
authors.forename: Guanyu
authors.initials: G
authors.lastname: Chen
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China.. Electronic address: zhangfj@sysucc.org.cn.
authors.forename: Fujun
authors.initials: F
authors.lastname: Zhang
authors.affiliation: Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, 651 Dongfeng Road, East, Guangzhou 510060, China.. Electronic address: gaof@sysucc.org.cn.
authors.forename: Fei
authors.initials: F
authors.lastname: Gao