DOI QR코드

DOI QR Code

Clinical outcome of high-dose-rate interstitial brachytherapy in patients with oral cavity cancer

  • Lee, Sung Uk (Proton Therapy Center, National Cancer Center) ;
  • Cho, Kwan Ho (Proton Therapy Center, National Cancer Center) ;
  • Moon, Sung Ho (Proton Therapy Center, National Cancer Center) ;
  • Choi, Sung Weon (Center for Specific Organs Cancer, National Cancer Center) ;
  • Park, Joo Yong (Center for Specific Organs Cancer, National Cancer Center) ;
  • Yun, Tak (Center for Specific Organs Cancer, National Cancer Center) ;
  • Lee, Sang Hyun (Center for Specific Organs Cancer, National Cancer Center) ;
  • Lim, Young Kyung (Proton Therapy Center, National Cancer Center) ;
  • Jeong, Chi Young (Proton Therapy Center, National Cancer Center)
  • Received : 2014.09.23
  • Accepted : 2014.12.08
  • Published : 2014.12.31

Abstract

Purpose: To evaluate the clinical outcome of high-dose-rate (HDR) interstitial brachytherapy (IBT) in patients with oral cavity cancer. Materials and Methods: Sixteen patients with oral cavity cancer treated with HDR remote-control afterloading brachytherapy using $^{192}Ir$ between 2001 and 2013 were analyzed retrospectively. Brachytherapy was administered in 11 patients as the primary treatment and in five patients as salvage treatment for recurrence after the initial surgery. In 12 patients, external beam radiotherapy (50-55 Gy/25 fractions) was combined with IBT of 21 Gy/7 fractions. In addition, IBT was administered as the sole treatment in three patients with a total dose of 50 Gy/10 fractions and as postoperative adjuvant treatment in one patient with a total of 35 Gy/7 fractions. Results: The 5-year overall survival of the entire group was 70%. The actuarial local control rate after 3 years was 84%. All five recurrent cases after initial surgery were successfully salvaged using IBT ${\pm}$ external beam radiotherapy. Two patients developed local recurrence at 3 and 5 months, respectively, after IBT. The acute complications were acceptable (${\leq}grade$ 2). Three patients developed major late complications, such as radio-osteonecrosis, in which one patient was treated by conservative therapy and two required surgical intervention. Conclusion: HDR IBT for oral cavity cancer was effective and acceptable in diverse clinical settings, such as in the cases of primary or salvage treatment.

Keywords

References

  1. Lau HY, Hay JH, Flores AD, Threlfall WJ. Seven fractions of twice daily high dose-rate brachytherapy for node-negative carcinoma of the mobile tongue results in loss of therapeutic ratio. Radiother Oncol 1996;39:15-8. https://doi.org/10.1016/0167-8140(95)01686-4
  2. Mazeron JJ, Ardiet JM, Haie-Meder C, et al. GEC-ESTRO recommendations for brachytherapy for head and neck squamous cell carcinomas. Radiother Oncol 2009;91:150-6. https://doi.org/10.1016/j.radonc.2009.01.005
  3. Rudoltz MS, Perkins RS, Luthmann RW, et al. High-dose-rate brachytherapy for primary carcinomas of the oral cavity and oropharynx. Laryngoscope 1999;109:1967-73. https://doi.org/10.1097/00005537-199912000-00013
  4. Erickson BA, Demanes DJ, Ibbott GS, et al. American Society for Radiation Oncology (ASTRO) and American College of Radiology (ACR) practice guideline for the performance of high-dose-rate brachytherapy. Int J Radiat Oncol Biol Phys 2011;79:641-9. https://doi.org/10.1016/j.ijrobp.2010.08.046
  5. Paine CH, Ash DV. Interstitial brachytherapy: past-present- future. Int J Radiat Oncol Biol Phys 1991;21:1479-83. https://doi.org/10.1016/0360-3016(91)90322-U
  6. Inoue T, Inoue T, Yoshida K, et al. Phase III trial of high- vs. low-dose-rate interstitial radiotherapy for early mobile tongue cancer. Int J Radiat Oncol Biol Phys 2001;51:171-5.
  7. Mendenhall WM, Van Cise WS, Bova FJ, Million RR. Analysis of time-dose factors in squamous cell carcinoma of the oral tongue and floor of mouth treated with radiation therapy alone. Int J Radiat Oncol Biol Phys 1981;7:1005-11. https://doi.org/10.1016/0360-3016(81)90151-6
  8. Wendt CD, Peters LJ, Delclos L, et al. Primary radiotherapy in the treatment of stage I and II oral tongue cancers: importance of the proportion of therapy delivered with interstitial therapy. Int J Radiat Oncol Biol Phys 1990;18:1287-92. https://doi.org/10.1016/0360-3016(90)90299-Y
  9. Ichimiya Y, Fuwa N, Kamata M, et al. Treatment results of stage I oral tongue cancer with definitive radiotherapy. Oral Oncol 2005;41:520-5. https://doi.org/10.1016/j.oraloncology.2004.12.012
  10. Nutting CM, Morden JP, Harrington KJ, et al. Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol 2011;12:127-36. https://doi.org/10.1016/S1470-2045(10)70290-4
  11. Sher DJ, Thotakura V, Balboni TA, et al. Treatment of oral cavity squamous cell carcinoma with adjuvant or definitive intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys 2011;81:e215-22. https://doi.org/10.1016/j.ijrobp.2011.02.023
  12. Daly ME, Le QT, Kozak MM, et al. Intensity-modulated radiotherapy for oral cavity squamous cell carcinoma: patterns of failure and predictors of local control. Int J Radiat Oncol Biol Phys 2011;80:1412-22. https://doi.org/10.1016/j.ijrobp.2010.04.031
  13. Sresty NV, Ramanjappa T, Raju AK, Muralidhar KR, Sudarshan G. Acquisition of equal or better planning results with interstitial brachytherapy when compared with intensity-modulated radio therapy in tongue cancers. Brachytherapy 2010;9:235-8. https://doi.org/10.1016/j.brachy.2009.05.006
  14. Eisbruch A, Levendag PC, Feng FY, et al. Can IMRT or brachytherapy reduce dysphagia associated with chemoradiotherapy of head and neck cancer? The Michigan and Rotterdam experiences. Int J Radiat Oncol Biol Phys 2007;69(2 Suppl):S40-2.
  15. Fujita M, Hirokawa Y, Kashiwado K, et al. Interstitial brachytherapy for stage I and II squamous cell carcinoma of the oral tongue: factors influencing local control and soft tissue complications. Int J Radiat Oncol Biol Phys 1999;44:767-75. https://doi.org/10.1016/S0360-3016(99)00068-1
  16. Matsuura K, Hirokawa Y, Fujita M, Akagi Y, Ito K. 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 1998;40:535-9. https://doi.org/10.1016/S0360-3016(97)00811-0
  17. Umeda M, Komatsubara H, Nishimatsu N, Yokoo S, Shibuya Y, Komori T. High-dose rate interstitial brachytherapy for stage I-II tongue cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;90:667-70. https://doi.org/10.1067/moe.2000.110087
  18. Hepel JT, Syed AM, Puthawala A, Sharma A, Frankel P. Salvage high-dose-rate (HDR) brachytherapy for recurrent head-andneck cancer. Int J Radiat Oncol Biol Phys 2005;62:1444-50. https://doi.org/10.1016/j.ijrobp.2004.12.078
  19. Shibuya H, Hoshina M, Takeda M, Matsumoto S, Suzuki S, Okada N. Brachytherapy for stage I & II oral tongue cancer: an analysis of past cases focusing on control and complications. Int J Radiat Oncol Biol Phys 1993;26:51-8. https://doi.org/10.1016/0360-3016(93)90172-R
  20. Bourgier C, Coche-Dequeant B, Fournier C, et al. Exclusive low- dose-rate brachytherapy in 279 patients with T2N0 mobile tongue carcinoma. Int J Radiat Oncol Biol Phys 2005;63:434-40. https://doi.org/10.1016/j.ijrobp.2005.02.014
  21. Pernot M, Hoffstetter S, Peiffert D, et al. Role of interstitial brachytherapy in oral and oropharyngeal carcinoma: reflection of a series of 1344 patients treated at the time of initial presentation. Otolaryngol Head Neck Surg 1996;115:519-26. https://doi.org/10.1016/S0194-5998(96)70006-2
  22. Notani K, Yamazaki Y, Kitada H, et al. Management of mandibular osteoradionecrosis corresponding to the severity of osteoradionecrosis and the method of radiotherapy. Head Neck 2003;25:181-6. https://doi.org/10.1002/hed.10171
  23. Leung TW, Wong VY, Kwan KH, et al. High dose rate brachytherapy for early stage oral tongue cancer. Head Neck 2002; 24:274-81. https://doi.org/10.1002/hed.10021
  24. Kakimoto N, Inoue T, Inoue T, et al. Results of low- and high- dose-rate interstitial brachytherapy for T3 mobile tongue cancer. Radiother Oncol 2003;68:123-8. https://doi.org/10.1016/S0167-8140(03)00055-0

Cited by

  1. Brachytherapy: Where Has It Gone…Again? vol.34, pp.10, 2014, https://doi.org/10.1200/jco.2015.65.0267