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A Journal on Otorhinolaryngology, Head and Neck Surgery,
Plastic Reconstructive Surgery, Otoneurosurgery
Indexed/Abstracted in: EMBASE, Scopus
Otorinolaringologia 1999 December;49(4):173-7
Radiotherapy in cancer of tongue base: use of “half beam shielding blocks” technique with 60Co. Personal experience
Antonello M., Polico R., Busetto M.
Ospedale Civile «Umberto I» - Mestre (Venezia) Unità Operativa di Radioterapia Oncologica
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Background. The results obtained in the treatment of tongue base carcinomas using γ photon of a Cobalt Unit and “half beam shielding blocks” technique are reported.
Methods. From January 1988 through December 1995, 69 patients affected with tongue base carcinoma were treated with radiation therapy at the Radiotherapy Department of Umberto I Hospital in Mestre, Italy. The patients were mostly males (M:F=4.75:1), their age ranging from 39-85 years (mean: 64.2 years). Staging, performed according to TNM classification (UICC criteria) showed 17 cases in stage II, 19 in stage III and 33 in stage IV, with prevalence of squamous cell carcinoma. Seventeen patients were treated with radical surgery. All patients were treated with radiotherapy with γ photon of a Cobalt Unit and using the “half beam shielding blocks” technique and junction level on the hyoid axis. Treatment planning was always studied on an extensive number of CT scans on which target volume and normal tissues were defined and performed using Theraplan V05 program, Theratronics. The dose to the target volume was 50 Gy/25 fractions after radical surgery and 60 Gy/30 fractions for exclusive radiotherapy and after non radical surgery.
Results. Overall 3-years and 5-years survival were 39% and 31% respectively (±0.0668), disease free 5-years survival was 39%. A better prognosis for initial stage lesions with statistically significant difference (p-value=0.0116), and for patients treated with radical surgery plus radiography (p-value=0.008) was obtained. Fifty-four patients obtained a complete remission; the other fifteen a partial remission. Twenty-one patients showed loco-regional relapse; thirty-six died, thirty of them with disease.
Conclusions. The data obtained show that the “half beam shielding blocks” technique can be used also with γ photon of a Cobalt Unit, and that the local control wasn’t obtained using the conventional doses and radiotherapy technique. Better results should be obtained using new radiotherapy techniques and new combined approaches.