• 9/20/2004
  • S. K. Jain, A. Kumar and J. K. Singh
  • Journal of Clinical Oncology, Annual Proceedings Vol 22, No 14S

Background: Since inception goal of radiotherapy is to deliver high dose to tumor with maximum sparing of normal tissue with brachytherpy there is rapid fall of dose beyond implanted area, thus delivering high dose to target with sparing of surrounding normal tissue. In early stage node negative oral cavity cancer surgery and radiotherapy produces equal result but radiotherapy is considered superior as it causes less functional and cosmetic deficit.
Method: We present 25 patient of oral cavity cancer treated with HDR brachytherapy alone or in combination with external beam radiotherapy (EBRT). Interstitial implant was done using flexible plastic tubing or rigid stainless steel needles under local or general anesthesia. A dose of 45 to 51 Gy in 15 to 17 fractions, 3 Gy per fraction, two fractions per day with a gap of 6hr in-between, was delivered with HDR brachytherpy alone. When combine with EBRT 24 to 30 Gy was delivered with HDR bracytherapy, and 36 to 40 Gy by EBRT.
Result: Complete clinical response was noted, in all the patients at six weeks of completion of RT. Two out of twenty five patients have local recurrence and were salvaged by surgery. Nodal failure was observed in two patients and was managed by radical neck dissection. With mean follow-up of fourteen months, all patients are alive disease free. Localize grade III mucositice was observed in all the patients, no grade III and grade IV late complications is seen in any of the patients.
Conclusions: HDR brachytherapy is highly effective in early stage oral cavity cancer; it gives excellent functional and cosmetic results in comparison with surgery. However long term follow-up is needed to comment further on these results.