Brachytherapy efficacy and safety in the treatment of primitive tongue carcinomas: experience from the Oscar Lambret Center.

Abstract

Purpose: The study aim was to evaluate efficacy and safety of brachytherapy for the treatment of early-stage tongue carcinoma and identify factors associated with the risk of local recurrence. The interest is to discuss the contribution of brachytherapy among therapeutics of tongue tumors treatments.

Patients and methods: Between January 2010 and December 2020, 55 patients with T1T2N0 tongue primitive squamous cell carcinomas were treated with interstitial low-dose-rate, pulsed-dose-rate, or high-dose-rate brachytherapy, with or without neck dissection, at the Centre Oscar Lambret of Lille. The primary objective was to evaluate the efficacy of brachytherapy in terms of local recurrence-free survival (LRFS). The secondary objectives were to estimate regional recurrence-free survival (RRFS), overall survival (OS), and to describe toxicities of brachytherapy.

Results: Local recurrence-free survival (LRFS) rates at 1-year, 3-years, and 5-years follow-up were 90.9 %, 62.9 %, and 49.4 %, respectively. The cumulative incidences of local recurrence at 1-year, 3-years, and 5-years follow-up were 1.8 %, 10.2 %, and 12.3 %, respectively; Overall survival (OS) rates at 1-year, 3-years, and 5-years follow-up were 90.9 %, 71.2 %, and 53.4 %, respectively, with a 95 % confidence interval (CI). We identified 14 (25.5 %) grade 3 complications and 10 (29.1 %) grade 2 complications. Age at diagnosis (p < 0.001), smoking (p = 0.018), and tumor stage (p = 0.009) were found to be significant prognostic factors (p < 0.05) for LRFS.

Conclusion: Brachytherapy is a moderate effective treatment option for early-stage tongue carcinoma. Despite the frequent toxicities generated this approach offers several notable advantages, including preservation of oral anatomy and functions, ultimately leading to an improved quality of life for patients.