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Proposed method to study the factors affecting local control with combined external beam and interstitial implantation of mobile tongue and floor of mouth
Author(s) -
Hintz Brace L.,
Kagan A. Robert,
Chan Paul,
Rao Aroor R.,
Nussbaum Herman,
Ryoo Monica C.,
Wollin Myron
Publication year - 1986
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930330415
Subject(s) - medicine , tongue , nuclear medicine , floor of mouth , external beam radiation , complication , external beam radiotherapy , cone beam ct , basal cell , radiation therapy , implant , surgery , radiology , brachytherapy , pathology , computed tomography
Abstract Twenty‐seven patients with squamous cell carcinoma of the mobile tongue and floor of the mouth were treated with external beam and interstitial radiation. Good prognostic factors were T 1 N 0 , T 2 N 0 , superficial tumors, tumor shrinkage by 75% with external beam, and no apparent tumor clinically 2 months after treatment. On the other hand, T 3 N 0 , T 1‐3 N 1 , and deeply necrotic tumors had a poor prognosis. We recommend using a flexible afterloading system to implant the initial local tumor volume (not just the residual nidus) that does not exceed 45 cm 3 . The minimum (reference) dose was prescribed to a surface 1/2 cm beyond the most peripheral rim of radioactive sources. For acceptable local control and complication rates, our suggested minimum (reference) doses are ⩽7,500 rads for T 1 (or a time‐dose‐fractionation [TDF] of 131‐140), <8,000 rads for T 2 (TDF of 131‐140), and probably < 8,500 rads for T 3 (TDF of ⩽ 150). These guidelines should be considered preliminary.