The role of afterloading iridium (Ir192) implant in the management of carcinoma of the tongue

A total of 86 patients with carcinoma of the tongue were treated between May 1, 1974 and June, 1978, at the Los Angeles County-University of Southern California Medical Center and California Hospital Medical Center, Los Angeles, California. Fifty-five of these patients were treated for primary tumors and 31 of the 86 patients were re-irradiated with interstitial Ir¹⁹² implants for recurrent or persistent tumors after “radical” external irradiation and/or surgery. Primary treatment consisted of a combination of external irradiation and an interstitial after loading Ir¹⁹² implant. In the primary treatment group, patients with T₁ and T₂ lesions showed control rates of 69% for the anterior two-thirds of the tongue (9 of the 13 patients) and 75 % for the posterior one-third of the tongue (3 of the 4 patients). For patients with T₃ and T₄ lesions, the control rates were 46 % (6 of the 13 patients) and 68 % (17 of the 25 patients) for the anterior two-thirds of the tongue and the base of the tongue respectively. In the re-irradiation group, 4 of the 13 patients (30 % ) with lesions of the anterior two-thirds of the tongue and 8 of the 18 patients (44 %) with lesions of the base of the tongue achieved local control. The follow-up period for all these patients was a minimum of 24 months.