Brachytherapy as part of the definitive management of squamous cancer of the base of tongue

Journal Article · Fri Dec 01 04:00:00 EST 1989 · International Journal of Radiation Oncology, Biology and Physics; (USA)

DOI:https://doi.org/10.1016/0360-3016(89)90542-7· OSTI ID:7105338

Harrison, L B; Sessions, R B; Strong, E W; Fass, D E; Nori, D; Fuks, Z ^[1]

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1. Memorial Sloan-Kettering Cancer Center, New York, NY (USA)

Between 1981 and 1986, 17 patients were treated at the Department of Radiation Oncology at the Memorial Sloan-Kettering Cancer Center with squamous cancer of the base of the tongue whose definitive treatment included brachytherapy. There were four patients with T1 lesions, six with T2, six with T3, and one with T4. In general, treatment consisted of 5000-5400 cGy with external beam radiation and 2000-3000 cGy boost to the base of tongue via an Ir-192 implant using afterloading catheters. Necks were managed with elective radiation alone in the N0 group (n = 5) or with radiation plus neck dissection in the N+ group (n = 12). Five patients who would have required laryngectomy had they undergone primary surgery received neoadjuvant chemotherapy followed by external beam and implant as part of a larynx preservation study that was being done at our institution (4-T3, 1-T2). The range of follow-up is 8 to 59 months, with median follow-up of 24 months. No patients have been lost to follow-up. Crude local control by T-Stage are as follows: T1-4/4, T2-5/6, T3-5/6, T4-1/1. Actuarial local control at 24 months is 87%. There have been no neck failures. There have been five patients who had soft tissue ulceration (STU) and one patient who had osteoradionecrosis (ORN). All soft tissue ulceration patients have been successfully managed conservatively. The patient with osteoradionecrosis is currently being managed. In 4 of these 6 cases, the implant was the initial therapeutic intervention and the entire tumor bed was implanted. On the other hand, when external beam was the initial treatment, the boost was administered to the smaller volume of residual disease. Overall, 4 of 7 patients who had implant first developed either soft tissue ulceration or osteoradionecrosis, as opposed to 2 of 10 patients who had implant after external beam and/or chemotherapy.

• OSTI ID: 7105338
• Journal Information: International Journal of Radiation Oncology, Biology and Physics; (USA), Journal Name: International Journal of Radiation Oncology, Biology and Physics; (USA) Vol. 17:6; ISSN IOBPD; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

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