Brachytherapy for Buccal Cancer: From Conventional Low Dose Rate (LDR) or Mold Technique to High Dose Rate Interstitial Brachytherapy (HDR-ISBT)

摘要

Background/Aim: To examine the effectiveness of newly-installed high-dose-rate interstitial brachytherapy (HDR-ISBT) for buccal cancer. Patients and Methods: We retrospectively reviewed 36 patients (25 men and 11 women) with buccal cancer treated with curative brachytherapy with or without external radiotherapy with a median follow-up of 99 months. A total of 15 HDR-ISBT (median 48 Gy/8 fractions, range= 24-60 Gy) patients were compared to conventional 15 cases LDR-ISBT (70 Gy, range= 42.8-110 Gy) and 7 molds techniques (15 Gy, range= 9-74 Gy). A total of 31 patients also underwent external radiotherapy (30 Gy, range= 24-48 Gy). They comprised of 3T1, 23 T2, 8 T3, 3 T4 including 11 node positive cases. Results: HDR-ISBT provided 82% of local control rate at 5 years, whereas conventional brachytherapy showed 72% [p= 0.44; LDR-ISBT (65%), mold therapy (85.7%)]. Patients with early lesions (T1-2 or stage I-II) showed better local control rates than those with advanced lesions (T3-4 or stage III-IV). Severe late grade 3 complications developed in two patients treated with LDR-ISBT and EBRT. There is no significant difference in toxicity grade <= 2 between conventional brachytherapy (5/15= 33%) and HDR-ISBT (7/32= 32%, p= 0.92). Conclusion: HDR-ISBT achieved good and comparable local control rates to conventional brachytherapy without elevating the toxicity.