CT-guided I brachytherapy in the treatment of distant metastases in the oral cavity and maxillofacial region.

PURPOSE

We aimed to evaluate the feasibility and clinical effectiveness of CT-guided I brachytherapy for distant oral and maxillofacial metastases.

MATERIALS AND METHODS

We retrospectively analyzed 65 patients with 84 distant oral and maxillofacial metastases. Thirty-one patients with 38 lesions received I brachytherapy (group A) and 34 with 46 lesions received external beam radiotherapy (EBRT; group B).

RESULTS

Median follow-up time was 16 months. The 3-, 6-, 12-, 18-, and 24-month local control rates for group A were 83.9%, 75.9%, 66.7%, 38.4%, and 25.0%, respectively; for group B they were 76.5%, 62.5%, 43.8%, 25.0%, and 0.0%, respectively (P<.05); the median local tumor progression-free survival times were 14 and 9 months, respectively. Group A had a better local tumor progression-free survival (LTPFS) relative to group B (P<.001; HR, 6.961 [95%CI, 2.109, 9.356]). Cox proportional hazards regression analysis indicated that I brachytherapy, tumor size, and primary pathological type were the independent factors affecting LTPFS. Additionally, I brachytherapy showed better performance in relieving patient clinical symptoms relative to EBRT (P<.05). Group A also had fewer complications than group B, especially regarding grade 3/4 complications according to Radiation Therapy Oncology Group grading criteria. Mean overall survival times in groups A and B were 17.1 and 14.8 months, respectively.

CONCLUSION

CT-guided I brachytherapy is feasible and safe for distant oral and maxillofacial metastases; it achieved a better local control rate, longer LTPFS and fewer complications without compromising overall survival compared with EBRT.