No abstract

No abstract

No abstract

An analysis has been undertaken of 45 patients with non-metastatic squamous cell carcinoma of the buccal mucosa treated by permanent 198Au or 222Rn implants and in most cases supplementary external irradiation. Eight patients had T1, 30 had T2, and 7 T3 disease. Of the lesions 21 were located in the buccal mucosal surface, 14 in the retromolar region, and 10 in the bucco-alveolar sulci. Seven of the 45 (16%) died of the disease and the actuarial 5-year survival rate was 81%. No obvious differences were noted in survival rate between different stages of the disease or between different subsites of the primary lesion. There were 6 local recurrences occurring from 3 to 33 months after treatment, and only one of these was salvageable by further radiation therapy. Neck node metastasis occurred in 11 cases from 2 to 34 months after treatment, and 8 of these cases responded successfully to a radical neck dissection or radiotherapy.

The records of 165 patients with squamous cell carcinoma of the oropharynx treated at our hospital with external and/or interstitial radiotherapy between 1971 and 1990 were reviewed to evaluate the treatment results, focusing on primary control and complications. All cancers were restaged according to the UICC 1987 TNM staging system. Of these 165 patients, 11% were in Stage I, 55% in Stage II, 24% in Stage III and 8.5% in Stage IV. Local control and complications were analysed in 140 patients. The remaining 25 patients died of intercurrent or metastatic disease during the first 2 years following treatment and were excluded from the analysis. 70 patients were treated by interstitial implant using permanent implant seeds (Rn-222 in eight patients, Au-198 in 62 patients) with or without external radiation. 56 other patients received external irradiation alone and another 14 patients received pre-operative external irradiation plus surgery. 2-year recurrence-free rates were 73% (100% for T1, 76% for T2, 36% for T3 tumours) in the patients who received interstitial implant with or without external radiation and 36% (67% for T1, 48% for T2, 13% for T3 tumours) in the patients treated by external irradiation alone. The incidence of soft-tissue or bone complications requiring long-term treatment was 14%. Based on these findings, it is believed that an interstitial implant using Au-198 grains combined with external beam irradiation is a useful treatment modality for small lesions of the oropharynx.