Disease control using low-dose-rate brachytherapy is unaffected by comorbid severity in oral cancer patients

Abstract

Objective: The aim of this study was to evaluate the outcome and complications of low-dose-rate brachytherapy (LDR-BT) for oral cancer according to comorbidity. Methods: The records of a total of 180 patients who received LDR-BT for T1-2N0M0 oral cancers between January 2005 and December 2007 were analysed. The comorbidities of the patients were retrospectively graded according to the Adult Comorbidity Evaluation-27, and the relationships between the comorbidity grades and survival, disease control and the incidence of complications were analysed. Results: The 2 year overall survival rates of patients with no comorbidity, Grade 1, Grade 2 and Grade 3 comorbidity were 87%, 85%, 76% and 65%, respectively, and the reduction in the survival rate according to comorbid severity was significant in a univariate analysis (p50.032) but not in a multivariate analysis including other clinical factors. Cause-specific survival, locoregional control and local control were not related to the comorbidity grade, or any other clinical factors. Grade 2 or 3 complications developed in 27% of the patients. The incidence of complications was unrelated to the comorbidity grade. Conclusion: The disease control of oral cancer and the incidence of complications after LDR-BT were not related to comorbid severity. LDR-BT is a useful and safe treatment for patients regardless of the presence of severe comorbidity.

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

“…198 Au grains are alternative sources used in our institution, usually prescribed for patients who cannot tolerate surgery, 192 Ir hairpins, or 137 Cs needles because of advanced patient age or poor performance status due to the presence of complications such as dementia, diabetes, or apoplexy [ 7 , 8 ]. 198 Au grains are small and can be easily applied under local anesthesia without causing severe pain or discomfort during the insertion and treatment [ 9 ].…”