INDICATIONS, TECHNIQUES AND RESULTS OF POSTOPERATIVE BRACHYTHERAPY INCANCER OF THE ORAL CAVITY

Purpose/objective: We tried to reduce the number of local recurrences after surgery and external beam irradiation (EBI) in carcinoma of the oral cavity, when margins were positive or close. Material and methods : From 1980 to 1992, we treated 97 cases of carcinomas of the oral cav ity by postoperative brachytherapy. Surgery was combined with EBI+brac hytherapy in 51 cases and with brachytherapy alone in 46 cases. We tre ated 29 T1, 34 T2, 30 T3T4 and four Tx (73% were NO at first examinati on and 23% had positive nodes). The type of surgery is analysed. Brach ytherapy was performed in one or two planes along the surgical scar. I f the mandibular rim was resected, especially when the tongue or the r emaining floor were sutured to the internal face of the inferior lip o r to the buccal mucosa, the bridge technique was used. To decrease the dose to the inferior part of the mandible, the bridge was modified th anks to experimental dosimetry. Results: At 5 years, the local control (LC) is 89%, the locoregional control (LRC) 82%, the specific surviva l (SS) 74% and the overall survival (OS) 67%. Complications: We noted 19% of grade 1 (minor), 12% of grade 2 (moderate) and 6% of grade 3 (m ajor) complications. Conclusion: Compared with the results of the lite rature, we think that postoperative brachytherapy can improve classica l radiosurgical results in selected cases with a risk of local recurre nce.