Aim: To study the importance of high-dose-rate (HDR) boost brachytherapy (BT) after percutaneous irradiation of base of tongue tumors.
Methods: Between 1992 and 2000 seventy patients with biopsy proven carcinoma of the base of tongue were treated with primary radiation therapy. Fourty patients received a mean dose of 61 Gy (range, 50-72 Gy) external beam irradiation, and afterwards 30 patients were treated with a mean dose of 18 Gy (range, 12-30 Gy) boost HDR BT. Prognostic factors were analyzed in uni- and multivariate model.
Results: At a median follow-up of 56 (16-108) months, boost BT increased the incidence of local tumor control (LTC) from 38% to 67% (p=0.0145). The 5-year probability of LTC was 60% vs. 36% (p=0.0188), the locoregional tumor control 52% vs. 34% (p=0.0753) and the overall survival (OS) 46% vs. 26% (p=0.0545), respectively, in favor of the boost group. Serious, grade 4 radiation toxicity occurred in 5% (2/40) and 13% (4/30) without or with boost treatment, respectively (p=0.2110). In multivariate analyses for LTC, tumor size (p=0.0042) and boost (p=0.0444), and for OS tumor size (p=0.0047) and nodal status (p=0.0163) had a significant effect.
Conclusion: Boost BT after teletherapy improves LTC significantly without considerable increase in the risk of side-effects.
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