World Journal of Epidemiology and Cancer Prevention Volume No 7

Research Open Access

Second Malignancy of the Oral Cavity after Brachytherapy for Tongue Cancer in Long-Term Follow-Up Patients

Eri Omoto, Hitoshi Shibuya, Keiko Nakagawa, Kiyomi Amemiya and Keiji Hayashi
World Journal of Epidemiology and Cancer Prevention 2014, 3:1



Brachytherapy is as effective as surgery for tumor control, with better functional and cosmetic results. When the primary treatment includes radiation therapy, however, a second malignancy (SM) may develop in the previously irradiated area. The present study investigated the incidence and treatment results of SM in the oral cavity after brachytherapy for tongue cancer.

Study design

A retrospective study was performed using medical records from our institution’s database.

Methods and Materials

A retrospective review of 281 patients who had been treated with brachytherapy for stage I or II tongue cancer between 1965 and 2000 was performed. All of the patients had been followed-up for more than 10 years at the Department of Diagnostic Radiology and Oncology, Tokyo Medical and Dental University Hospital.


SM of the oral cavity occurred in 26 (9.3%) of the 281 patients between 8 and 32 years after brachytherapy. Twenty of these patients underwent surgery, and their 4-year overall survival rate was 94.4%. Four patients received a second brachytherapy treatment because of the presence of inoperable and/or unresectable lesions, but all of these treatments failed; 3 of the patients died of SM at a median of 1.8 years after the diagnosis. One patient received laser treatment and another patient received chemotherapy, but both of these patients died of uncontrolled SM at 2 months and 5 months after the diagnosis of SM. 


SM can occur in the oral cavity after brachytherapy for tongue cancer during a long-term follow-up period. In such cases, surgery is the only successful salvageable treatment.


tongue cancer, treatment results, brachytherapy

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