External and interstitial radiation therapy of carcinoma of the oral tongue. A review of 32 years' experience

Fu, Karen K.; Ray, Jyotirmoy; Chan, Eric K.; Phillips, Theodore L.

doi:10.2214/ajr.126.1.107

Cited by 56 publications

(8 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…If LDR brachytherapy is used as a single modality in treating cancer of the oral cavity, the recommended dose is 65-70 Gy prescribed at a reference dose rate between 30-50 cGy/h [23,271, with as a consequence an overall treatment time limited to about 1 week, For such schedules an increase of local tumor control as com pared with conventional ERT alone or conventional ERT combined with an interstitial implant was observed, with an acceptable number of (late) normal tissue complications [3,7,18,[22][23][24]. However, due to variations in dose distribution, tumor size and irradiated volume, a straightforward comparison of LDR brachytherapy and conventional ERT is not possible.…”

Section: Clinical Reference Doses O F Ldr Brachytherapy In Head and Nmentioning

confidence: 99%

Constraints in the use of repair half times and mathematical modelling for the clinical application of HDR and PDR treatment schedules as an alternative for LDR brachytherapy

Pop

Broek

Visser

et al. 1996

Radiotherapy and Oncology

View full text Add to dashboard Cite

Using theoretical models based on radiobiological principles for the design of new treatment schedules for HDR and PDR brachytherapy, it is important to realise the impact of assumptions regarding the kinetics of repair. Extrapolations based on longer repair half times in a continuous LDR reference scheme may lead to the calculation of dangerously high doses for alternative HDR and PDR treatment schedules. We used the clinical experience obtained with conventional ERT and LDR brachytherapy in head and neck cancer as a clinical guideline to check the impact of the radiobiological parameters used. Biologically equivalent dose (BED) values for the in clinical practice of LDR brachytherapy recommended dose of 65-70 Gy (prescribed at a dose rate between 30-50 cGy/h) are calculated as a function of the repair half time. These BED values are compared with the biological effect of a clinical reference dose of conventional ERT with 2 Gy/day and complete repair between the fractions. From this comparison of LDR and ERT treatment schedules, a range of values for the repair half times of acute or late responding tissues is demarcated with a reasonable fit to the clinical data. For the acute effects (or tumor control) the best fits are obtained for repair half times of about 0.5 h, while for late effects the repair half times are at least 1 h and can be as high as 3 h. Within these ranges of repair half times for acute and late effects, the outcome of'alternative5 HDR or PDR treatment schedules are discussed. It is predominant ly the late reacting normal tissue with the longer repair half time for which problems will be encountered and no or only marginal gain is to be expected of decreasing the dose rate per pulse in PDR brachytherapy.

show abstract

Section: Clinical Reference Doses O F Ldr Brachytherapy In Head and Nmentioning

confidence: 99%

Constraints in the use of repair half times and mathematical modelling for the clinical application of HDR and PDR treatment schedules as an alternative for LDR brachytherapy

Pop

Broek

Visser

et al. 1996

Radiotherapy and Oncology

View full text Add to dashboard Cite

show abstract

“…12 reported better local control in a group of patients who were treated with combination therapy with external radiation of< 40 Gy (92%) than in the group treated with combination therapy with external radiation of _> 40 Gy (64%). Fu et al 8 and Mendenhall et al) 1 also reported similar findings. These findings seem to be reasonable because the doses delivered with external irradiation at the primary tumor site were closely connected with tumor volume.…”

Section: Discussionmentioning

confidence: 56%

Retrospective study of results of interstitial radiotherapy for cancer of the tongue

et al. 1996

View full text Add to dashboard Cite

Background: This retrospective study was carried out to clarify whether interstitial radiotherapy is effective in the management of carcinoma of the tongue. Methods:The subjects were 65 previously untreated patients with invasive squamous cell carcinoma of the anterior two-thirds of the tongue who received mainly interstitial radiotherapy using 137Cs needles with or without external irradiation between 1977 and 1993. Results:The local control rate was 80% for T1, 73% for T2, 57% for T3 and 73% overall. Thirteen of 16 patients for whom local control failed achieved good control by salvage surgery. The local control rates were slightly lower with combined radiotherapy (64%) than with the interstitial radiotherapy alone (78%), but there was no significant difference between external radiation (< 30 Gy) and external radiation (> 30 Gy). Cervical lymph node metastases developed in 26% of patients with T1-3 NO. Neck control was achieved in 20 (74%) of 27 patients in whom pathologically positive nodes were found. Twentytwo patients developed soft tissue or/and mandibular complications for a total of 28 cases. Soft tissue complications were more likely to occur in patients who received interstitial radiotherapy alone. On the other hand, mandibular complications were l ikelyto occur in patientswho received external irradiation. The cumulative 5-year survival rate was 92% for T1,72% for T2 and 33% for T3. The 5-year survival rate of patients with subsequent cervical node metastases was 41%, whereas in patients without subsequent cervical node metastases it was 89% (P < 0.001). Conclusions:Interstitial radiotherapy with or without external irradiation has useful implications in the local control of newly diagnosed cases of tongue cancer. If local recurrence develops, it is possible to control the primary lesion and prolong survival by salvage surgery. The most effective treatment modality for neck control and survival could not be determined from this study.

show abstract

“…the small fraction of patients that would potentially benefit from elective neck dissection does not justify the procedure in the large number of TxNo patients that would receive no benefit. Fu, et al, 4 also report that neck recurrence can be controlled with a radical neck dissection in 80% of patients in whom the primary is controlled b~ the initial treatment. This control rate does not mclude one-third of their patients with neck metastases developing after treatment .of the primary lesion who were given no further therapy, and no patient was controlled when a combined resection was required for a recurrent primary.…”

Section: Discussionmentioning

confidence: 97%

Carcinoma Of the Mobile Tongue: Incidence of Cervical Metastases in Early Lesions Related to Method of Primary Treatment

Js¹,

Rp²

1983

The Laryngoscope

View full text Add to dashboard Cite

One hundred thirty-eight patients receiving initial treatment for squamous cell carcinoma of the mobile tongue from 1960 to 1978 were reviewed to determine the frequency of cervical metastasis in early carcinoma (T1N0 and T2N0). Occult cervical node metastasis in an elective neck dissection or subsequent neck recurrence in an initially negative neck was found in 14.5% (9/62) of patients staged T1N0 and 30.6% (11/36) of patients staged T2N0. Refinement of the staging system demonstrated that 9.7% (3/31) of patients with a primary lesion less than or equal to 1.0 cm and a clinically negative neck (T1aN0) subsequently developed a cervical metastasis. Patients with primary lesions greater than 1.0 cm but less than or equal to 2.0 cm (T1bN0) had twice the risk of occult cervical metastasis (19.4% or 6/31). The crude 5-year survivals in Stage I for radium alone, partial glossectomy, and partial glossectomy with neck dissection were 64%, 58% and 75% respectively and in Stage II were 31%, 66% and 71% respectively. Local-regional failure is the principal mechanism of failure in patients treated locally particularly in Stage II.

show abstract

External and interstitial radiation therapy of carcinoma of the oral tongue. A review of 32 years' experience

Abstract: ABSTRACT:In 204

Cited by 56 publications

References 5 publications

Constraints in the use of repair half times and mathematical modelling for the clinical application of HDR and PDR treatment schedules as an alternative for LDR brachytherapy

Constraints in the use of repair half times and mathematical modelling for the clinical application of HDR and PDR treatment schedules as an alternative for LDR brachytherapy

Retrospective study of results of interstitial radiotherapy for cancer of the tongue

Carcinoma Of the Mobile Tongue: Incidence of Cervical Metastases in Early Lesions Related to Method of Primary Treatment

Contact Info

Product

Resources

About