We analyzed the efficacy of two different therapeutic procedures in 42 cases with T1 and early T2 tongue carcinoma. Fourteen cases underwent partial glossectomy including 2 cases receiving elective neck dissection, and 28 cases receiving interstitial brachytherapy using iridium in 17 cases, microselectron in 8 cases and iridium with external irradiation in 3 cases. More than 90 percent of cases survived beyond the 5-year follow up and the 5-year disease-specific survival did not show any significant difference between the surgically treated group and the brachytherapy group. However, 5-year disease-free survival showed a tendency toward a high recurrence rate in the brachytherapy group (57.2%) compared to that in the surgically treated group (28.6%). In the surgically treated group there were 4 regional recurrences of which 3 could be salvaged. The remaining one case demonstrated multiple metastases to bone and liver. In the brachytherapy group 10 of 14 regional recurrences occurred in a half year and regional failures caused to death in 2 cases.
Thus successful regional and distant control is crucial for treatment of early tongue carcinoma and awaits novel diagnostic procedures for potentially metastatic nodes which may play a key role in the distant spread of tongue carcinoma.
