Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer

Abstract

PurposeTo evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer.Materials and MethodsSixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using 192Ir between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions.ResultsThe 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT ± external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (≤grade 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention.ConclusionHDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.

Adjuvant high-dose-rate brachytherapy in the management of oral cavity cancers: 5 years of experience in Iran

“…Kakimoto et al indicated 71% three-year local control in T3 mobile tongue cancers with definitive HDR-BT [ 22 ]. In patients with definitive HDR-IBT, Lee et al showed five-year overall survival and three-year local control of 70% and 84%, respectively [ 23 ]. As evident, our outcomes are in agreement with the other reports despite the extensive variety in patient characteristics and treatment composition of surgery, external radiotherapy, and brachytherapy.…”