HIGH DOSE RATE BRACHYTHERAPY IN PRIMARY AND RECURRENT TONGUE CANCER

고선량율 근접 방사선치료법을 이용한 원발성 및 재발된 설암의 치료

  • Lee, Ui-Lyong (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Lee, Jong-Ho (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Choung, Pill-Hoon (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Kim, Myung-Jin (Department of Oral and Maxillofacial Surgery, College of Dentistry, Seoul National University) ;
  • Park, Joo-Yong (Oral Cancer Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Choi, Sung-Weon (Oral Cancer Clinic, Research Institute and Hospital, National Cancer Center) ;
  • Cho, Kwan-Ho (Center for Proton Therapy, Research Institute and Hospital, National Cancer Center)
  • 이의룡 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 이종호 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 정필훈 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 김명진 (서울대학교 치과대학 구강악안면외과학교실) ;
  • 박주용 (국립암센터 구강종양클리닉) ;
  • 최성원 (국립암센터 구강종양클리닉) ;
  • 조관호 (국립암센터 양성자치료센터)
  • Published : 2006.09.30

Abstract

Low-dose rate brachytherapy(LDR) has been effective modality for treatment of oral cancer. But the disadvantage of LDR is radioexposure of medical staff. To overcome this problem, high dose rate(HDR) brachytherapy has been developed. Our study evaluates the outcomes of patients with tongue cancer as treated by HDR brachytherapy. Between 2002 and 2005, eight patients with carcinoma of the tongue were treated with HDR brachytherapy. Five patients had AJCC stage I or II disease and the remaining three patients had AJCC stage III or IV. The male-to-female ratio was 2:6 and the mean age was 60.1 years (range: 21-80 years).The median follow-up time was 23.8 months (range: 7-55 months). There was no local failure until now. Three patients showed some complications. Two patients showed soft tissue necrosis. There was no bone sequela in all cases. Our experience in treating tongue cancer with HDR brachytherapy is encouraging, because it gave a satisfactory local control. Prospective studies are necessary to delineate the optimum indication for this treatment modality and long-term outcome.

Keywords

References

  1. Decroix Y, Ghossein NA : Experience of the Curie Institute in the treatment of cancer of the mobile tongue. Treatment policies and results. Cancer 47 : 496, 1981 https://doi.org/10.1002/1097-0142(19810201)47:3<496::AID-CNCR2820470312>3.0.CO;2-Q
  2. Mazeron JJ, Crook JM, Marinello G et al : Prognostic factors of local outcome for T1, T2 carcinomas of oral tongue treated by iridium 192 implantation. Int J Radiat Oncol Biol Phys 19 : 281, 1990 https://doi.org/10.1016/0360-3016(90)90535-R
  3. Ogino I, Kitamura T, Okajima H et al : Highdose-rate intracavotary brachytherapy in the treatment of cervical and vaginal intraepithelial neoplasia. Int J Radiat Oncol Biol Phys 40 : 881, 1998 https://doi.org/10.1016/S0360-3016(97)00924-3
  4. Rodriguez RR, Demanes DJ, Altieri GA : High dose rate brachytherapy in the treatment of prostate cancer. Hematol Oncol Clin North Am 13 : 503, 1999 https://doi.org/10.1016/S0889-8588(05)70071-X
  5. Lau HY, Hay JH, Flores AD et al : Seven fractions of twice daily high dose-rate brachytherapy for node-negative carcinoma of the mobile tongue result in loss of therapeutic ratio. Radiother Onco 39 : 15, 1996 https://doi.org/10.1016/0167-8140(95)01686-4
  6. Leung TW, Wong VY, Wong CM et al : High dose rate brachytherapy for carcinoma of the oral tongue. Int J Radiat Oncol Biol Phys 39 : 1113, 1997 https://doi.org/10.1016/S0360-3016(97)00376-3
  7. Mazeron JJ, Crook JM, Benck V et al : Iridium 192 implantation of T1 and T2 carcinoma of the mobile tongue. Int J Radiat Oncol Biol Phys 19 : 1369, 1990 https://doi.org/10.1016/0360-3016(90)90346-L
  8. Matsuura K, Hirokawa Y, Fujita M et al : Treatment results of stage I and II oral tongue cancer with interstitial brachytherapy: maximum tumor thickness is prognostic of nodal metastasis. Int J Radiat Oncol Biol Phys 40 : 535, 1998 https://doi.org/10.1016/S0360-3016(97)00811-0
  9. 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 16 : 358, 1994 https://doi.org/10.1002/hed.2880160410
  10. Hareyama M, Nishio M, Saito A et al : Results of cesium needle interstitial implantation for carcinoma of the oral tongue. Am J Otolaryngol 25 : 29, 1993
  11. Horiuchi J, Okuyama T, Shibuya H et al : Results of brachytherapy for cancer of the tongue with special emphasis on local prognosis. Int J Radiat Oncol Biol Phys 25 : 29, 1993 https://doi.org/10.1016/0360-3016(93)90141-H
  12. 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 carcinoma treated exclusively by irradiation. Int J Radiat Oncol Biol Phys 29 : 673, 1994 https://doi.org/10.1016/0360-3016(94)90553-3
  13. Naoya K, Takehiro I, Toshihiko I et al : Result of lowand high-dose-rate interstitial brachytherapy for T3 mobile tongue cancer. Radiothe Oncol 68 : 123, 2003 https://doi.org/10.1016/S0167-8140(03)00055-0
  14. Emmer R, Joan TJ, Ricardo C et al : Brachytherapy in the treatment of Stage IV carcinoma of the base of tongue. Brachytherapy 3 : 41, 2004 https://doi.org/10.1016/j.brachy.2004.02.001
  15. Masahiro U, Hideki K, Naruki N et al : High-dose rate interstitial brachytherapy for stage I-II tongue cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90 : 667, 2000 https://doi.org/10.1067/moe.2000.110087
  16. Inoue TA, Inoue TO, Teshima T et al : Phase III trial of high and low dose rate brachytherapy for node-negative carcinoma of the mobile tongue results in loss of therapeutic ratio. Radiother Oncol 39 : 15, 1996 https://doi.org/10.1016/0167-8140(95)01686-4
  17. Byers RM, Bland KI, Borlase B : The prognostic and therapeutic value of frozen section determinations in the surgical treatment of squamous carcinoma of the head and neck. Am J Surg 136 : 525, 1978 https://doi.org/10.1016/0002-9610(78)90275-1
  18. Looser KG, Shah JP, Strong EW : The significance of 'positive' margins in surgically resected epidermoid carcinomas. Head Neck Surg 1 : 107, 1978 https://doi.org/10.1002/hed.2890010203
  19. Peters LJ, Gorpfert H, Ang KK et al : Evaluation of the dose for postoperative radiation therapy of head and neck cancer: First report of a prospective randomized trial. Int J Radiat Oncol Biol Phys 26 : 3, 1993 https://doi.org/10.1016/0360-3016(93)90167-T
  20. Rudolts MS, Benammar A, Mohiuddin M : Does pathologic node status affect local control in patients with carcinoma of the head and neck treated with radical surgery and postoperative radiotherapy- Int J Radiat Oncol Biol Phys 31 : 503, 1995 https://doi.org/10.1016/0360-3016(94)00394-Z
  21. Beitler JJ, Smith RV, Silver CE et al : Close or positive margins after surgical resection for the head and neck cancer patient: The addition of brachytherapy improves local control. Int J Radiat Oncol Biol Phys 36 : 1039, 1998
  22. Chao KS, Emami B, Akhileswaran R et al : The impact of surgical margin status and use of an interstitial implant on T1, T2 oral tongue cancers after surgery. Int J Radiat Oncol Biol Phys 36 : 1039, 1996
  23. Michel L, Marc AB, Severine R et al : Postoperative brachytherapy alone and combined postoperative radiotherapy and brachytherapy boost for squamous cell carcinoma of the oral cavity, with positive or close margin. Head Neck 26 : 216, 2004 https://doi.org/10.1002/hed.10377
  24. Michel L, Sylvette H, Didier P et al : Postoperative brachytherapy alone for T1-2 N0 squamous cell carcinoma of the oral tongue and floor of mouth with close or positive margins. Head Neck 48 : 37, 2000
  25. Pernot M, Luporsi E, Hoffstetter S : Complication following definitive irradiation for cancers of oral cavity and the oropharynx(in a series of 1134 patients). Int J Radiat Oncol Biol Phys 37 : 577, 1997 https://doi.org/10.1016/S0360-3016(96)00612-8