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To analyze the long term local control, overall survival and toxicity in Carcinoma Buccal Mucosa patients treated with interstitial brachytherapy

This analysis included patients diagnosed as Carcinoma Buccal Mucosa on biopsy and treated with radical brachytherapy or External Beam Radiotherapy (EBRT) followed by brachytherapy boost. All patients received HDR Interstitial brachytherapy. The total dose was 35Gy in ten fractions for brachytherapy alone. Patients who received EBRT (50-54Gy) were boosted by brachytherapy to a dose of 18-24Gy in 6-8 fractions. All patients were treated using CT based planning

Between 2007 to 2017, 24 patients of Carcinoma Buccal Mucosa received HDR interstitial brachytherapy either alone or as a boost. Majority of the patients were tobacco chewers (80%). 17(71%) patients were clinical stage T2N0M0 and 7(29%) were clinically T1N0M0. The five year overall survival rate was 80%. At a median follow up of 7 years (3-12 years), the local control rate was 100% in stage I and 88% in stage II. Two patients developed nodal recurrence and one patient developed distant metastasis within two years of treatment. Tumor size (<3 cm vs. ≥3 cm) and brachytherapy technique (radical vs boost) did not impact local control or overall survival (p>0.05). The incidence of Grade 1 or 2 late toxicity was 8%. None of the patients developed Grade 3 or more late toxicities except one patient who developed osteoradionecrosis of the mandible

Interstitial brachytherapy in early stage Buccal Mucosa cancer either alone or as a boost provides excellent local control and overall survival with acceptable toxicity