Low-dose-rate interstitial brachytherapy preserves good quality of life in buccal mucosa cancer patients.

PURPOSE

To determine the results and long-term changes in radiation toxicity of stage I-II buccal mucosa cancer patients treated by low-dose-rate (LDR) brachytherapy with (198)Au grains.

MATERIALS AND METHODS

A total of 133 stage I-II buccal mucosa carcinomas patients received (198)Au grain implantation brachytherapy between January 1982 and July 2005: 75 of them were treated by (198)Au grain implantation alone and 58 were treated by (198)Au implantation in combination with external irradiation. The average (198)Au-grain dose was 70 Gy in 7 days. Gross tumor areas ranged from 2.4 cm(2) to 9 cm(2), and the clinical target areas ranged from 6 cm(2) to 15 cm(2).

RESULTS

The follow-up periods ranged from 3 months to 20 years (mean: 5 years 11 months and median: 5 years 1 months). Failure at the site of the primary lesion occurred in 17 patients. Post-treatment mucosal ulceration developed in 15 patients, and all were cured within 25 months by conservative treatment. Osteoradionecrosis was diagnosed in 8 patients, but only one patient required surgical treatment. No severe complications or aggravation of complications developed more than 10 years after treatment.

CONCLUSIONS

The results of low-dose-rate (LDR)-brachytherapy (BT) alone and LDR-BT in combination with external irradiation at a total dose of 25 Gy were acceptable from the standpoint of cure rate and QOL.