Low-dose-rate Interstitial Brachytherapy Preserves Good Quality of Life in Buccal Mucosa Cancer Patients

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Purpose: To determine the results and long-term changes in radiation toxicity of stage I-II buccal mucosa cancer patients treated by low-dose-rate (LDR) brachytherapy with 198Au grains. Materials and Methods: A total of 133 stage I-II buccal mucosa carcinomas patients received 198Au grain implantation brachytherapy between January 1982 and July 2005: 75 of them were treated by 198Au grain implantation alone and 58 were treated by 198Au implantation in combination with external irradiation. The average 198Au-grain dose was 70 Gy in 7 days. Gross tumor areas ranged from 2.4 cm2 to 9 cm2, and the clinical target areas ranged from 6 cm2 to 15 cm2. Results: The follow-up periods ranged from 3 months to 20 years (mean: 5 years 11 months and median: 5 years 1 months). Failure at the site of the primary lesion occurred in 17 patients. Post-treatment mucosal ulceration developed in 15 patients, and all were cured within 25 months by conservative treatment. Osteoradionecrosis was diagnosed in 8 patients, but only one patient required surgical treatment. No severe complications or aggravation of complications developed more than 10 years after treatment. Conclusions: The results of low-dose-rate (LDR)-brachytherapy (BT) alone and LDR-BT in combination with external irradiation at a total dose of 25 Gy were acceptable from the standpoint of cure rate and QOL.