Incidence of late complications with high dose rate interstitial brachytherapy for tongue cancer measured by the Brinkman index

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We investigated treatment results and late complications of high-dose-rate (HDR) interstitial brachytherapy (ISBT) for early (T1NO, T2NO) mobile tongue cancer using a microSelectron-HDR (Nucletron, Veenendaal, the Netherlands). Seventy-two patients with early stage squamous cell carcinomas of the mobile tongue were treated between January 1993 and April 2001 with microSelectron-HDR ISBT at the Department of Radiology, Osaka University Hospital. Tumors were located at the lateral border and ventral surface of the mobile tongue. Eighteen percent of the cases were treated with a combination of prior external radiation and HDR-ISBT, and 82% were treated with HDR-ISBT alone. The cases receiving HDR-ISBT alone were treated with a total dose of 54 Gy/9 fractions/5 days or 60Gy/10 fractions/8 days. In the combined therapy with an external dose of 30 Gy to 40 Gy, HDR-ISBT was administered with a total dose of 42-50 Gy. The Brinkman index and alcohol index were used for analysis of the incidence of late complications after HDR-ISBT. The 2- and 3-year local control rates were 85% and 82%, respectively. Fifteen of 72 patients (21%) treated with HDR-ISBT had late complications. Ten of 15 patients (67%) with late complications had a score greater than 600 with the Brinkman index. These results indicate there is a possibility of late complications when the Brinkman index is greater than 600.