Effect of intersource spacing on local control and complications in brachytherapy of mobile tongue and floor of mouth

Radiother Oncol. 1993 Jan;26(1):19-25. doi: 10.1016/0167-8140(93)90021-y.

Abstract

From 1971 to 1988, 133 T1 and 141 T2 biopsy-proven squamous cell carcinomas of mobile tongue and floor of mouth were definitively managed by Iridium-192. Implantations were performed using either guide gutters or afterloading plastic catheters. The prescribed dose at the reference isodose (85% of the basal dose rate, Paris system) was 60-70 Gy. Total dose was not adjusted to dose rate or tumor volume. Results of the 274 implants have been analysed to look for a possible influence of intersource spacing on local control and necrosis. Follow up for patients free of local recurrence is 1-180 months with median of 35 months. The 274 tumors were divided into two groups according to intersource spacing: 9-14 mm (n = 204), and 15-20 mm (n = 70). At 5 years, the estimated local control (Kaplan Meier) was 86% and 76%; respectively (p = 0.13); the necrosis rate was 33% and 46%, respectively (p = 0.04). Multivariate analysis shows that dose and activity of wires were significantly related to local control, while only tumor site was predictive of necrosis; there was a non-statistically significant relationship between intersource spacing of wires and local control (p = 0.055). When considering only patients with oral tongue cancers, necrosis was significantly related to activity of wires (p = 0.013), and there was a non-significant trend to a relationship between necrosis and intersource spacing (p = 0.066) and tumor diameter (p = 0.065). For patients with floor of mouth cancer, none of these factors was significantly related to necrosis.(ABSTRACT TRUNCATED AT 250 WORDS)

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Brachytherapy / adverse effects
  • Brachytherapy / methods*
  • Carcinoma, Squamous Cell / radiotherapy*
  • Female
  • Humans
  • Iridium Radioisotopes / therapeutic use
  • Male
  • Middle Aged
  • Mouth Floor
  • Mouth Neoplasms / radiotherapy*
  • Necrosis
  • Neoplasm Recurrence, Local
  • Tongue Neoplasms / radiotherapy*
  • Treatment Failure

Substances

  • Iridium Radioisotopes