Comparison of external beam radiation therapy and radioactive implants in the management of nonmetastatic oral squamous cell cancer: an analysis of the surveillance epidemiology and end results database

Objective. Radiotherapy in oral squamous cell carcinoma (OSCC) could be either through external beam (EBRT) or brachytherapy (BT). In third-world countries, access to novel treatment like BT is limited. This study aimed to compare survival in patients with OSCC treated with EBRT with BT recipients. Methods. We examined cases of nonmetastatic OSCC between January 1, 1987, and December 31, 2007, in the surveillance epidemiology and end results (SEER) registry. A Cox proportional hazards model was used to determine the adjusted relationship between radiation type and survival. Results. There was no significant difference in survival (adjusted) between patients who were treated with BT and those treated with EBRT (P = .330). However, combining EBRT + BT was associated with significantly better survival compared with EBRT alone (hazard ratios [HR] = 0.61, P < .001) or BT alone (HR = 0.70, P = .024). Conclusions. The effect of BT on survival was not significantly different from EBRT. (Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:38-45)