BRACHYTHERAPY FOR STAGE-I AND STAGE-II ORAL TONGUE CANCER - AN ANALYSIS OF PAST CASES FOCUSING ON CONTROL AND COMPLICATIONS

An analysis of the therapy used for 370 tongue cancer patients has bee n made, said patients having been treated by interstitial irradiation alone or by combined external irradiation and brachytherapy (Stage I: 90 cases, IIa: 196 cases; and IIb: 84 cases). The neck was followed by close follow-up (304 cases), treated by elective neck irradiation (56 cases), or underwent operation at the time of local recurrence (10 ca ses). The results have shown that the 5-year survivals for Stages I, I Ia, and IIb were 84%, 78%, and 72%, respectively. Further, the 5-year primary control was 85% for tumors of the superficial type, 79% for tu mors of the exophytic type, and 45% for tumors of the infiltrative typ e (p < 0.004). In non-electively irradiated patients, a neck metastasi s occurred in 31% in Stage I, 41% in Stage IIa, and 51% in Stage IIb. Finally, 110 patients incurred radiation-induced complications (110/29 1 = 38%) and 11 patients (11/291 = 4%) required a surgical procedure. Brachytherapy for tongue cancer achieved results that are comparable w ith surgery. The analysis also revealed that the introduction of compu ter dosimetry and the use of a spacer (a dental guard) in brachytherap y have achieved superior results in the management of a tongue cancer.