Sole high dose-rate interstitial brachytherapy for early-stage tongue cancer: A systematic review

Abstract

Purpose: Brachytherapy has the advantage of preserving organs and function, which is of great interest to tongue cancer patients. High dose-rate brachytherapy is a newer form of brachytherapy with the advantage of higher dose conformity than the popular low dose-rate brachytherapy. This article aims to summarize the literature on sole high dose-rate brachytherapy for early-stage tongue cancer, its treatment characteristics, its treatment outcomes, toxicity and reassess its therapeutic benefits.

Materiel and methods: A systematic review was done in Medline database using the search engine PubMed. Keywords for the search included interstitial, brachytherapy and tongue cancer. Articles included had to study the outcome of the use of exclusive high dose-rate brachytherapy for early-stage tongue cancer.

Results: Eleven articles were eligible comprising 305 patients. The median follow-up ranged from 21 to 53.5 months. The most frequently utilized technique delivered a dose of 60Gy in ten fractions (two daily fractions) for one week or five days. Late effects and toxicity were minimal; soft tissue and mandibular bone necrosis occurred in 37 patients (12 %). Local control rates at five years and three years ranged from 65 to 100 % and 71 to 94.7 %, respectively. Cause-specific and overall survival ranged from 57 to 94 % and 46 to 89.4 %, respectively.

Conclusion: Sole interstitial high dose-rate brachytherapy is a safe and efficient treatment option for early tongue cancer. The main advantage found is its high local control rate resulting to superior organ function preservation. Sole interstitial high dose-rate brachytherapy is a viable treatment option for early-stage tongue cancer.

Keywords: Brachytherapy; Cancer de la langue; Curiethérapie; Haut débit de dose; High dose-rate; Interstitial radiotherapy; Radiothérapie interstitielle; Tongue cancer.