Pierre Mattei1, Emilien Chabrillac2, Bastien Cabarrou3, Agnès Dupret-Bories2, Sébastien Vergez2,4, Jérôme Sarini2, Raphaël Lopez5, Lucie Piram6, Thomas Brun7, Anouchka Modesto6. 1. Department of Surgery, University Cancer Institute Toulouse-Oncopole, 1 Avenue Irène Joliot-Curie, 31059, Toulouse, France. mattei.p@chu-toulouse.fr. 2. Department of Surgery, University Cancer Institute Toulouse-Oncopole, 1 Avenue Irène Joliot-Curie, 31059, Toulouse, France. 3. Department of Biostatistics, Institut Claudius Regaud, University Cancer Institute Toulouse-Oncopole, 1 Avenue Irène Joliot-Curie, 31059, Toulouse, France. 4. Department of Head and Neck Surgery, Centre Hospitalier Universitaire Rangueil-Larrey, 24 Chemin de Pouvourville, 31400, Toulouse, France. 5. Department of Maxillofacial Surgery, Toulouse University Hospital, Pierre-Paul Riquet Hospital, Allée Jean Dausset, 31300, Toulouse, France. 6. Department of Radiation Therapy, University Cancer Institute Toulouse-Oncopole, 1 Avenue Irène Joliot-Curie, 31059, Toulouse, France. 7. Department of Engineering and Medical Physics, University Cancer Institute Toulouse-Oncopole, 1 Avenue Irène Joliot-Curie, 31059, Toulouse, France.
Abstract
OBJECTIVE: This study aims to assess the outcomes of adjuvant interstitial brachytherapy (BT) to the tumor bed for oral cavity squamous cell carcinoma (SCC), and to compare the oncological outcomes and toxicity profile of low-dose-rate (LDR) and pulsed-dose-rate (PDR) BT. DESIGN: This retrospective single-center study included all patients who underwent postoperative LDR- or PDR-BT to the tumor bed as the sole adjuvant treatment for an oral tongue or floor of the mouth SCC between January 2000 and December 2020. RESULTS: A total of 79 patients were eligible for this study. The cohort was divided into an LDR group (n = 38) and a PDR group (n = 41). The median time interval between surgery and brachytherapy was 55 days. Median delivered total dose was 55 Gy and median hospital stay was 5 days. Five patients (8.3%) experienced grade 3-4 early toxicity, 2 in the LDR group and 3 in the PDR group. Late toxicities were present in 28 patients (44.4%) and were dominated by grade 1-2 residual pain and dysesthesia, without a statistical difference between the groups. After a median follow-up of 65.1 months, 5‑year local control (LC), disease-free survival (DFS), and overall survival (OS) for the whole cohort were 76.3% (95% CI = 63.4-85.1), 61.6% (95% CI = 49.0-72.0), and 71.4% (95% CI = 58.6-80.8), respectively. CONCLUSION: Adjuvant BT after excision of oral cavity SCC provides satisfactory oncological outcomes along with good tolerance. In our study, PDR-BT showed similar oncological and functional results to LDR-BT in this indication.
OBJECTIVE: This study aims to assess the outcomes of adjuvant interstitial brachytherapy (BT) to the tumor bed for oral cavity squamous cell carcinoma (SCC), and to compare the oncological outcomes and toxicity profile of low-dose-rate (LDR) and pulsed-dose-rate (PDR) BT. DESIGN: This retrospective single-center study included all patients who underwent postoperative LDR- or PDR-BT to the tumor bed as the sole adjuvant treatment for an oral tongue or floor of the mouth SCC between January 2000 and December 2020. RESULTS: A total of 79 patients were eligible for this study. The cohort was divided into an LDR group (n = 38) and a PDR group (n = 41). The median time interval between surgery and brachytherapy was 55 days. Median delivered total dose was 55 Gy and median hospital stay was 5 days. Five patients (8.3%) experienced grade 3-4 early toxicity, 2 in the LDR group and 3 in the PDR group. Late toxicities were present in 28 patients (44.4%) and were dominated by grade 1-2 residual pain and dysesthesia, without a statistical difference between the groups. After a median follow-up of 65.1 months, 5‑year local control (LC), disease-free survival (DFS), and overall survival (OS) for the whole cohort were 76.3% (95% CI = 63.4-85.1), 61.6% (95% CI = 49.0-72.0), and 71.4% (95% CI = 58.6-80.8), respectively. CONCLUSION: Adjuvant BT after excision of oral cavity SCC provides satisfactory oncological outcomes along with good tolerance. In our study, PDR-BT showed similar oncological and functional results to LDR-BT in this indication.
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