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Iridium 192 implantation of T1 and T2 carcinomas of the mobile tongue.
- Source :
-
International journal of radiation oncology, biology, physics [Int J Radiat Oncol Biol Phys] 1990 Dec; Vol. 19 (6), pp. 1369-76. - Publication Year :
- 1990
-
Abstract
- 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.
- Subjects :
- Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell mortality
Carcinoma, Squamous Cell pathology
Female
Humans
Male
Middle Aged
Radiotherapy adverse effects
Radiotherapy Dosage
Survival Rate
Tongue Neoplasms mortality
Tongue Neoplasms pathology
Brachytherapy
Carcinoma, Squamous Cell radiotherapy
Iridium Radioisotopes therapeutic use
Tongue Neoplasms radiotherapy
Subjects
Details
- Language :
- English
- ISSN :
- 0360-3016
- Volume :
- 19
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- International journal of radiation oncology, biology, physics
- Publication Type :
- Academic Journal
- Accession number :
- 2262360
- Full Text :
- https://doi.org/10.1016/0360-3016(90)90346-l