198Au grain implantation for early tongue cancer in patients of advanced age or poor performance status

摘要

Brachytherapy using ¹⁹⁸Au grains is minimally invasive and the only curative treatment for early tongue cancer in patients of advanced age or poor performance status available in our institution. From March 1993 to February 2008, ¹⁹⁸Au grains were used to treat a group of 96 Stage I–II tongue cancer patients who could not undergo surgery or brachytherapy using ¹⁹²Ir pins because of an advanced age (≥75 years) or poor performance status (≥2). The patients were followed for 3.9 ± 3.3 years, and the cause-specific survival and local control rates were determined. Survival analyses were performed using the Kaplan-Meier method, and univariate and multivariate analyses were performed using the Cox proportional hazard model. The results were compared with those for a group of 193 early tongue-cancer patients who underwent treatment using iridium pins. The 5-year cause-specific survival and local control rates of the ¹⁹⁸Au grains group were 71% and 68%, respectively, both of which were 16% lower than the corresponding rates for the ¹⁹²Ir pins group. Our study demonstrated that as the last curative treatment available, ¹⁹⁸Au grain implantation could be used to achieve moderate treatment results for early tongue cancer in patients of advanced age or poor performance status.