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. 2011 Aug;84(1004):747-9.
doi: 10.1259/bjr/23130739. Epub 2010 Aug 3.

Brachytherapy for tongue cancer in the very elderly is an alternative to external beam radiation

R Khalilur  1 , K Hayashi, H Shibuya
Affiliations

Brachytherapy for tongue cancer in the very elderly is an alternative to external beam radiation

R Khalilur et al. Br J Radiol. 2011 Aug.

Abstract

Background: The result of curative treatment for very elderly patients with tongue carcinoma has not been reported to date. We retrospectively reviewed the results of brachytherapy in 125 the patients aged over 75 years.

Methods: The results of brachytherapy in 125 patients, 75 years old or older, with Stage I or II squamous cell carcinoma of the oral tongue were reviewed. The 125 cases consisted of 31 Stage I and 94 Stage II cases; 67 patients were under 80 years old and 58 were over 80 years old. All patients were treated using low-dose-rate brachytherapy ((198)Au/(222)Rn: 59 cases; (192)Ir: 38 cases; (226)Ra/(137)Cs: 28 cases).

Results: None of the patients stopped treatment during the course of brachytherapy. The 3 year and 5 year control rates of the primary lesions were both 86%. Post-brachytherapy neck node metastasis was diagnosed in 43 cases and radical neck dissection was performed for 24 cases (21 of the 24 cases were under 80 years old). As a result, the 7 year disease-specific survival (DSS) rate for patients aged under 80 years old was 70% and 41% for those over 80 years old (p = 0.03).

Conclusion: The brachytherapy for elderly patients with tongue cancer was safe, and the control of the primary lesion was almost the same as in younger patients. However, modalities available to treat neck node metastasis are limited. More conservative surgical approaches combined with post-operative irradiation may be advocated for neck node metastasis for elderly patients with tongue cancer.

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Figures

Figure 1
Figure 1
Local control in the cases as a whole.
Figure 2
Figure 2
Overall survival in the cases as a whole.
Figure 3
Figure 3
Overall disease-specific survival (DSS) in the cases as a whole.
Figure 4
Figure 4
Cause-specific survivals of patients with tongue cancer at Stage II. ys, years.
See this image and copyright information in PMC

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