Brachytherapy for stage I & II oral tongue cancer: an analysis of past cases focusing on control and complications

Abstract

An analysis of the therapy used for 370 tongue cancer patients has been made, said patients having been treated by interstitial irradiation alone or by combined external irradiation and brachytherapy (Stage I:90 cases, IIa: 196 cases; and IIb: 84 cases). The neck was followed by close follow-up (304 cases), treated by elective neck irradiation (56 cases), or underwent operation at the time of local recurrence (10 cases). The results have shown that the 5-year survivals for Stages I, IIa, and IIb were 84%, 78%, and 72%, respectively. further, the 5-year primary control was 85% for tumors of the superficial type, 79% for tumors of the exophytic type, and 45% for tumors of the infiltrative type (p < 0.004). In non-electively irradiated patients, a neck metastasis occurred in 31% in Stage I, 41% in Stage IIa, and 51% in Stage IIb. Finally, 110 patients incurred radiation-induced complications (110/291 = 38%) and 11 patients (11/291 = 4%) required a surgical procedure. Brachytherapy for tongue cancer achieved results that are comparable with surgery. The analysis also revealed that the introduction of computer dosimetry and the use of a spacer (a dental guard) in brachytherapy have achieved superior results in the management of a tongue cancer.