Stage I and II mobile tongue carcinomas treated by external radiation and gold seed implantation

The purpose of this study was to analyze the influence of a protocol modification, in which the use of gold seeds was extended and elective neck irradiation was applied, on the treatment results of early carcinoma of the tongue. We analyzed 225 patients with Stage I (93 patients) and Stage II (132 patients) squamous cell carcinomas of the oral tongue. We compared the results between the two periods before (171 patients) and after (54 patients) the modification. The main alterations were the expanded use of gold seeds for tumors less than 5 mm in thickness and the application of elective irradiation for T2 tumors. The 5-year primary control and survival rates improved from 81% to 97% and from 81% to 93%, respectively. The occurrence of late complications-lingual muscle and mandibular bone necroses-was found not to deteriorate after the modification. We concluded that the modification was adequate.