Oncologic and functional outcome of base of tongue cancer treated with external-beam radiation and I-192 implant

This paper assesses tumor control and functional outcome for squamous cancer of the base of the tongue managed with external irradiation plus Ir-192 implant. Between January 1981 and June 1990, 36 previously untreated patients were treated with 5,000-5,400 cGy of external-beam radiation plus a 2,000-3,000 cGy boost to the base of tongue with an Ir-192 implant. Negative necks were irradiated alone, and positive necks were treated with irradiation followed by neck dissection. Crude local control by T stage are as follows: T1, 10 of 11; T2, 13 of 14; T3, 8 of 10; and T4 1 of 1. Actuarial local control is 87.5%. Of the four local failures, two were salvaged by surgery. Neck control was achieved in 35 of 36 patients. Complications occurred in 25%. When implantation was done with the nonlooping technique, the injury rate was statistically higher than when done with the looping technique (6 of 12 = 50% vs 3 of 24 = 12.5%, P = .02)