eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
Current Issue Archive Supplements Articles in Press Journal Information Aims and Scope Editorial Office Editorial Board Register as Author Register as Reviewer Instructions for Authors Abstracting and indexing Subscription Advertising Information Links
SCImago Journal & Country Rank

Interview with Professor Janusz Skowronek
ABS 2015
1/2018
vol. 10
 
Share:
Share:
more
 
 
abstract:
Original paper

Long-term outcome of high-dose-rate brachytherapy and perioperative brachytherapy in early mobile tongue cancer

Mahadev Potharaju, Hemanth Raj, Manavalan Muthukumaran, Murali Venkataraman, Bhargavi Ilangovan, Selvan Kuppusamy

J Contemp Brachytherapy 2018; 10, 1: 64–72
Online publish date: 2018/02/28
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Purpose
To evaluate long-term outcome of high-dose-rate brachytherapy and perioperative brachytherapy in early mobile tongue cancer.

Material and methods
Seventy-three patients with clinically staged T1/T2 N0 M0 of mobile tongue cancer were studied retrospectively. Between January 2000 and September 2010, 47 patients underwent high-dose-rate brachytherapy (HDR-BT) alone and 26 patients underwent perioperative brachytherapy (PB). Endpoints were overall survival, disease-free survival, loco-regional control, and late side effects.

Results
Median age was 52 years and median follow-up was 74 months (range, 60-180). There were no local recurrences in the PB group. Overall survival at 6 years was 74.7% vs. 92.3% in HBR BT and PB group, respectively (p = 0.032). Disease-free survival at 6 years was 55.3% vs. 92.3% respectively in HDR-BT and PB (p = 0.002). Disease-free survival at 6 years in tumor histologic grade 1/2 patients was 76.3 months versus 40% in grade 3 patients. Nodal recurrence-free rate at 6 years was 67.5% with HDR-BT only, and 96.2% with PB (p = 0.007). In HDR BT only group, nodal recurrence-free rate at 6 years in T1 patients was 89.8% versus 29.4% in T2 patients. 16% and 7% patients developed soft tissue necrosis and osteoradionecrosis, respectively. Multivariate Cox proportional hazards analysis revealed significant correlation of local recurrence with tumor grade (p = 0.029), nodal recurrence with T-stage (p = 0.007), and disease-free survival with age (p = 0.003) and T stage (p = 0.026).

Conclusions
HDR-BT alone gives acceptable loco-regional control in T1 tumors. T2 stage tumors should not be treated by brachytherapy alone in view of high failure rates in nodal regions and should undergo either neck dissection or nodal irradiation. Perioperative brachytherapy is investigational and can be considered in patients who are at high-risk for local recurrence in patients undergoing surgery alone.

keywords:

head and neck, HDR, perioperative brachytherapy, tongue cancer

references:
Jemal A, Bray F, Center MM et al. Global Cancer Statistics. CA Cancer J Clin 2011; 61: 69-90.
Warnakulasuriya S. Global epidemiology of oral and oropharyngeal cancer. Oral Oncol 2009; 45: 309-316.
Fein DA, Mendenhall WM, Parsons JT et al. Carcinoma of the oral tongue: a comparison of results and complications of treatment with radiotherapy and/or surgery. Head Neck 1994; 16: 358-365.
Pernot M, Malissard L, Hoffstetter S et al. The study of tumoral, radiobiological, and general health factors that influence results and complications in a series of 448 oral tongue carcinomas treated exclusively by irradiation. Int J Radiat Oncol Biol Phys 1994; 29: 673-679.
D’Cruz AK, Vaish R, Kapre N et al. Elective versus therapeutic neck dissection in node negative oral cancer. N Engl J Med 2015; 373: 521-529.
Shim SJ, Cha J, Koom WS et al. Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy [serial online]. Radiat Oncol 2010; 5: 43.
Yuen AP, Ho CM, Chow TL et al. Prospective randomized study of selective neck dissection versus observation for N0 neck of early tongue carcinoma. Head Neck 2009; 31: 765-772.
Al-Rajhi N, Khafaga Y, El-Husseiny J et al. Early stage carcinoma of oral tongue: prognostic factors for local control and survival. Oral Oncol 2000; 36: 508-514.
Kligerman J, Lima RA, Soares JR et al. Supraomohyoid neck dissection in the treatment of T1/T2 squamous cell carcinoma of the oral cavity. Am J Surg 1994; 168: 391-394.
Hicks WL Jr, North JH Jr, Loree TR et al. Surgery as a single modality therapy for squamous cell carcinoma of the oral tongue. Am J Otolaryngol 1998; 19: 24-28.
Sobin LH, Gospodarowicz MK, Wittekind C: UICC: TNM classification of malignant tumours. 7th ed. Wiley-Blackwell, Oxford 2009.
Spiro RH, Strong EW. Epidermoid carcinoma of the mobile tongue-treatment by partial glossectomy alone. Am J Surg 1971; 122: 707-710.
Decroix Y, Ghossein NA. Experience of the Curie Institute in treatment of cancer of the mobile tongue. Cancer 1981; 47: 496-502.
Parikh HK, Rao RS, Sukhthankar P et al. Surgery in early cancer of the oral tongue (T1-2). Wide excision versus hemiglossectomy. Indian J Otolaryngol Head Neck Surg 1998; 50: 349-353.
Ganly I, Patel S, Shah J. Early stage squamous cell cancer of the oral tongue – clinicopathologic features affecting outcome. Cancer 2012; 118: 101-111.
Liu JC, Sopka DS, Mehra R et al. Early oral tongue cancer initially managed with surgery alone: Treatment of recurrence. World J Othorhinolaryngol Head Neck Surg 2016; 2: 193-197.
Urashima Y, Nakamura K, Shioyama Y et al. Treatment of early tongue carcinoma with brachytherapy: results over a 25-year period. Anticancer Res 2007; 27: 3519-3523.
Vermund H, Brennhovd I, Kaalhus O et al. Incidence and control of occult neck node metastases from squamous cell carcinoma of the anterior two-thirds of the tongue. Int J Radiat Oncol Biol Phys 1984; 10: 2025-2036.
Cunningham MJ, Johnson JT, Myers EN et al. Cervical lymph node metastasis after local excision of early squamous cell carcinoma of the oral cavity. Am J Surg 1986; 152: 361-366.
Keski-Säntti H, Atula T, Törnwall J et al. Elective neck treatment versus observation in patients with T1/T2 N0 squamous cell carcinoma of oral tongue. Oral Oncol 2006; 42: 96-101.
Lim YC, Lee JS, Koo BS et al. Treatment of contralateral N0 neck in early squamous cell carcinoma of the oral tongue: elective neck dissection versus observation. Laryngoscope 2006; 116: 461-465.
Shibuya H, Hoshina M, Takeda M et al. Brachytherapy for stage I & II oral tongue cancer: an analysis of past cases focusing on control and complications. Int J Radiat Oncol Biol Phys 1993; 26: 51-58.
Balasubramanian D, Ebrahimi A, Gupta R et al. Tumor thickness as a predictor of nodal metastasis in oral cancer: Comparison between tongue and floor of mouth subsites. Oral Oncol 2014; 50: 1165-1168.
Umeda M, Komatsubara H, Nishimatsu N et al. High-dose rate interstitial brachytherapy for stage I–II tongue cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000; 90: 667-670.
Tsai CJ, Hofstede TM, Sturgis EM et al. Osteoradionecrosis and radiation dose to the mandible in patients with oropharyngeal cancer. Int J Radiat Oncol Biol Phys 2013; 85: 415-420.
Fujita M, Hirokawa Y, Kashiwado K et al. An analysis of mandibular bone complications in radiotherapy for T1 and T2 carcinoma of the oral tongue. Int J Radiat Oncol Biol Phys 1996; 34: 333-339.
Wendt CD, Peters LJ, Delclos L et al. Primary radiotherapy in the treatment of stage I and II oral tongue cancers: Importance of the proportion of therapy delivered with interstitial therapy. Int J Radiat Oncol Biol Phys 1990; 18: 1287-1292.
Reuther T, Schuster T, Mende U et al. Osteonecrosis of the jaws as a side effect of radiotherapy of the head and neck tumor patients - a report of a thirty-year retrospective review. Int J Oral Maxillofac Surg 2003; 32: 289-295.
Civantos FJ, Zitsch RP, Schuller DE et al. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas. Results of a prospective multi-institutional trial. J Clin Oncol 2010; 28: 1395-1400.
Ross GL, Soutar DS, Gordon MacDonald D et al. Sentinel lymph node biopsy in head and neck cancer: preliminary results of a multicenter trial. Ann Surg Oncol 2004; 11: 690-696.
Schilling C, Stoeckli SJ, Haerle SK et al. Sentinel European Node Trial (SENT): 3-year results of sentinel node biopsy in oral cancer. Eur J Cancer 2015; 51: 2777-2784.
 
Quick links
© 2018 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe