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Base‐of‐Tongue Cancer: Survival, Function, and Quality of Life After External‐Beam Irradiation and Brachytherapy
Author(s) -
Robertson Matt L.,
Gleich Lyon L.,
Barrett William L.,
Gluckman Jack L.
Publication year - 2001
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200108000-00009
Subject(s) - brachytherapy , medicine , radiation therapy , neck dissection , quality of life (healthcare) , tongue , surgery , dissection (medical) , survival analysis , cancer , radiology , pathology , nursing
Objective Base‐of‐tongue cancer has traditionally been treated by surgical resection followed by radiation therapy. Primary radiation therapy with brachytherapy has recently been proposed as an alternative. In a prior analysis, we found that patients with advanced tongue‐base cancer treated by total glossectomy and postoperative radiation therapy can be cured while potentially maintaining good quality of life. Therefore, we designed the current study to assess survival, function, and quality of life in our patients with tongue‐base cancer who were treated with primary radiation therapy and brachytherapy with neck dissection as indicated. Study Design Consecutive case series. Methods Twenty patients were treated between 1993 and 1997 using the approach just named. The T stages were T1 (3), T2 (10), T3 (6), and T4 (1). The N stages were N0 (3), N1 (3), N2 (11), and N3 (3). At the time of brachytherapy catheter placement, neck dissections were performed in all 14 patients with N2 or N3 disease. Surviving patients completed a functional status survey and quality of life questionnaire. Results The 3‐ and 5‐year Kaplan‐Meier corrected actuarial survival rates were 57% and 38%, respectively. Eight patients remained alive at the time of this writing and completed the functional status survey and quality of life assessment. Function and quality of life were well maintained in patients treated with external‐beam irradiation followed by brachytherapy and neck dissection. However, none of our patients with T3 disease had long‐term survival. Conclusion Although we do not endorse external‐beam irradiation and brachytherapy for advanced tongue‐base cancers, this treatment should be strongly considered for patients with T1 or T2 tumors in whom preservation of function and quality of life is a priority.