Usefulness of 198Au grain implants in the treatment of oral and oropharyngeal cancer

Stage I and II Mobile Tongue Carcinomas Treated by External Radiation and Gold Seed Implantation

“…In contrast, some studies have reported an increase of soft tissue complications with use of combined external irradiation (3,10). The reduction in the external dose was recommended to reduce complication rates including soft tissue ulceration (15). In our department, all patients received external radiation with a total dose of 25 Á/30 Gy before brachytherapy.…”

“…These studies reported excellent results equivalent to those with a needle or hairpin source, especially for early tumors (T1 or T2) (7,11). With regard to cancer of the tongue, a negative indication for gold seed implantation has been determined (15). It was applied only to those patients who could not tolerate the implantation of the needle source due to complicated disease or advanced age, or who had recurrent tumors (16).…”

“…The sources were mostly applied to cancers arising in the floor of the mouth and buccal mucosa where the needle source could not be used due to the anatomy. Horiuchi et al (15) reported that patients with carcinoma of the mouth floor and the buccal mucosal accounted for 31.6% (56) and 23.7% therapy. These studies reported excellent results equivalent to those with a needle or hairpin source, especially for early tumors (T1 or T2) (7,11).…”

“…Gold seeds were supplied weekly by the Japan Isotope Association and are frequently used for oral cancer treatment in Japan as a source of permanent implantation (10,12,15,16). Brachytherapy using this source has several advantages.…”

“…In cases of radium and cesium needles, the period of implantation was adjusted to give a dose of 60 Gy at a distance of 5 mm from the tumor margin. Radon or gold seeds were usually implanted submucosally at 5 mm depth with 1 cm intervals as described previously (15,16), and the minimum dose of 60 Gy was administered at a 5-mm distance from the tumor margin. In 1980, a dosage planning computer system (Modulex (R) computer system; Kanematsu Corp. Japan) was introduced to calculate the dose distribution (Fig.…”