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Thursday, October 2, 2014
Is brachytherapy needed?
Hello. I am a 28 year-old woman. I had squamous cell carcinoma on my basal tongue. In my first surgery in 2010-12-13, two tumors were removed. The size of the bigger one was about 1*1.5 cm. This surgery didn`t completely remove the tumor. This caused the tumor to develop to my lymph and salivary nodes. The tumor in the second surgery in 2010-12-31 was removed completely and one of my salivary nodes was removed, too. The pathology results showed that my lymph nodes were not involved. Also, the size of removed part of my tongue was 2.5*2*1.5 cm. Since probably my case is a T1 stage, I wonder whether brachytherapy is needed or not? Does brachytherapy affects my speech?
According to the information you provided the lesion was totally excised with negative margins and the lymph nodes were negative. I assume you had a neck dissection. This would make this lesion a T1N0. Just based on that I do not believe that any further treatment is necessary. In addition very few centers in this country use brachytherapy for the tongue base. The only reason to use radiation in your situation would be if the surgeon is not satisfied of the margins. In most institutions external beam radiation using IMRT would be used.
Pierre Lavertu, MD, FRCS(C), FACS
Professor of Otolaryngology-Head and Neck Surgery
School of Medicine
Case Western Reserve University