Iridium 192 implantation of T1 and T2 carcinomas of the mobile tongue

Journal Article · Sat Dec 01 00:00:00 EST 1990 · International Journal of Radiation Oncology, Biology and Physics; (USA)

DOI:https://doi.org/10.1016/0360-3016(90)90346-L· OSTI ID:6210841

Mazeron, J J; Crook, J M; Benck, V; Marinello, G; Martin, M; Raynal, M; Haddad, E; Peynegre, R; Le Bourgeois, J P; Walop, W ^[1]

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1. Hopital Henri Mondor, Creteil (France)

Between 1970 and 1986, 166 patients with T1 or T2 epidermoid carcinomas of the mobile tongue were treated by iridium 192 implantation (70 T1N0, 83 T2N0, 13 T1-2 N1-3). Five-year actuarial survival was 52% for T1N0, 44% for T2aN0, and 8% for or T1-2 N1-3. Cause specific survivals were 90%, 71%, and 46%, respectively. Local control was 87% for both T1N0 and T2N0, and 69% for T1-2 N1-3. Seven of 23 failures were salvaged by surgery, increasing local control to 96% for T1 and 90% for T2. Thirty-six patients developed a minor or moderate necrosis (16% T1, 28% T2). Half of these involved bone but only five required surgical intervention. Both local control (LC) and necrosis (nec) increased with increasing dose but improvement beyond 65 Gy is minimal (less than or equal to 60 Gy: LC = 78% nec = 13%; 65 Gy: LC = 90% nec = 29%; greater than or equal to 70 Gy: LC = 94% nec = 23%). For N0 patients, neck management consisted of surveillance (n = 78), elective neck dissection followed with external irradiation for pathologically positive nodes (n = 72), or irradiation (n = 3). Clinically positive nodes (13 patients) were managed by either neck dissection followed by external irradiation if pathologically positive (n = 10) or irradiation alone (n = 3). Regional control was 79% for N0 patients, improving to 88% after surgical salvage, and was 9/13 for N1-3 patients. We recommend that T1 and T2 carcinomas of the mobile tongue be treated by iridium 192 implantation to deliver 65 Gy. Mandibular necrosis should be reduced by using an intra-oral lead-lined dental mold.

• OSTI ID: 6210841
• Journal Information: International Journal of Radiation Oncology, Biology and Physics; (USA), Vol. 19:6; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARCINOMAS
RADIOTHERAPY
TONGUE
IRIDIUM 192
IRRADIATION PROCEDURES
PATIENTS
RADIATION DOSES
RADIATION SOURCE IMPLANTS
SURVIVAL CURVES
BETA DECAY RADIOISOTOPES
BETA-MINUS DECAY RADIOISOTOPES
BETA-PLUS DECAY RADIOISOTOPES
BODY
DAYS LIVING RADIOISOTOPES
DIGESTIVE SYSTEM
DISEASES
DOSES
ELECTRON CAPTURE RADIOISOTOPES
HEAVY NUCLEI
IMPLANTS
INTERNAL CONVERSION RADIOISOTOPES
IRIDIUM ISOTOPES
ISOMERIC TRANSITION
ISOTOPES
MEDICINE
NEOPLASMS
NUCLEAR MEDICINE
NUCLEI
ORAL CAVITY
ORGANS
RADIATION SOURCES
RADIOISOTOPES
RADIOLOGY
THERAPY
550603* - Medicine- External Radiation in Therapy- (1980-)