Will High Dose Rate Interstitial Brachytherapy Be a Surrogate to Surgery in Early Mobile Squamous Cell Carcinoma of Tongue—An Indian Experience

• 作者: Gangotri Selvarajan K. S. Reddy Mourougan Sinnathambi Muzamil Asif Parthasarathy Vedasoundaram Saravanan Kandasamy Vivekanandam Singhavajhala
• 来源期刊: 医学物理学、临床工程、放射肿瘤学(英文)
• 学科: 医学
• 关键词: TONGUE Cancer High Dose Rate INTERSTITIAL BRACHYTHERAPY ORGAN PRESERVATION
• 年，卷（期）: 2014,（3）
• 页码范围: 143-155
• 页数: 13页
• 分类号: R73

摘要

The study was intended to highlight functional outcome and survival advantage when High Dose Rate (HDR) interstitial implant was used for anterior 2/3rd tongue, either as a primary or as boost depending upon stage of disease. Materials and Methods: Fifty-one patients with squamous cell carcinoma of anterior 2/3rd tongue received interstitial brachytherapy either as primary or as boost with Iridium 192 remote after loading high dose rate (Microselectron or Gamma MediX) machines from November 2008 to September 2013. Age group ranged from 32 to 73 years, mean 52.1. Of these 51, 37 were males and 14 were females. 8 patients belonged to Stage I, 18 from Stage II and 28 patients were Stage III. Stage I patients received primary brachytherapy alone of dose 38.50 Gy to 40 Gy and fraction dose ranged from 250 cGy to 350 cGy. Stage II and Stage III patients received external beam radiation of dose 44 Gy/200cGy per fraction for 22 fractions followed by spinal cord sparing for 6 Gy/200cGy per fraction for 3 fractions. Brachytherapy boost of dose 21 Gy was delivered after external beam radiation. Stage III patients received concurrent chemotherapy with Injection Cisplatin along with external beam radiotherapy 44 Gy/200cGy per fraction for 22 fractions followed by spinal cord sparing for 6 Gy/200cGy per fraction for 3 fractions. Brachytherapy boost of dose 21 Gy was delivered after external beam radiation. 55% of patients were habituated to tobacco and alcohol in one form or the other or both. Surprisingly 45% of patients were nonsmokers and non-alcoholic. Results: Follow-up period ranged from eight months to sixty months. 42 patients had complete response. 9 patients had residual disease. 2 patients died due to non-cancerous cause though they had excellent local control, one with pulmonary tuberculosis and the other with massive Myocardial Infarction. 2 patients died due to disease progression. Overall complete response rate was 82.35%. Those patients who had good coverage index and conformal index had good response compared