Our results lead us to interpret that interstitial brachytherapy with Ir-192 offers excellent local control rates with preservation of organ and function. Penectomy can be reserved as a means for effective salvage.

The sequential combination of limited surgery and tumor bed brachytherapy with or without external radiotherapy has been established as an effective alternative to more ablative procedures like amputation. Histologic grade has proven to be a significant factor determining local control.

A retrospective study of 399 cases of buccal cancer, presenting to the Tata Memorial Hospital, Bombay, during January to December 1984 was undertaken to define the efficacy of various treatment modalities in different clinical stages. Analysis of treatment technique and response was carried out in 185 cases that completed adequate therapy. Sixty percent of patients with stage I and II disease (21/35) received radiation therapy alone as the primary modality of treatment. Patients (150) with stage III or IV disease received palliative irradiation (57 cases), radical surgery (54 cases), or a combination of both (39 cases). The 2-year disease-free survival (DFS) rates were 48% for radiotherapy and 46% for surgery in the early stages and 5% and 33%, respectively, for advanced stages. Radiotherapy with a modified technique is recommended for the early-stage cancers and preoperative irradiation with adjuvant chemotherapy or hyperthermia for the advanced stages.