Is Radiation Therapy a Preferred Alternative to Surgery for Squamous Cell Carcinoma of the Base of Tongue?

• Published in: Journal of clinical oncology Vol. 18; no. 1; pp. 35 - 42
• Main Authors: MENDENHALL, W. M, STRINGER, S. P, AMDUR, R. J, HINERMAN, R. W, MOORE-HIGGS, G. J, CASSISI, N. J
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Baltimore, MD American Society of Clinical Oncology 01-01-2000; Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Female; Florida - epidemiology; Follow-Up Studies; Humans; Logistic Models; Male; Medical sciences; Middle Aged; Multivariate Analysis; Neoplasm Metastasis; Neoplasm Recurrence, Local - epidemiology; Radiation therapy and radiosensitizing agent; Radiotherapy - adverse effects; Radiotherapy, Adjuvant; Survival Rate; Tongue Neoplasms - mortality; Tongue Neoplasms - pathology; Tongue Neoplasms - radiotherapy; Tongue Neoplasms - surgery; Treatment with physical agents; Treatment. General aspects; Tumors; Florida; Human; Squamous cell carcinoma; Treatment; Stomatology; Surgery; Treatment efficiency; Oral cavity disease; Malignant tumor; Tongue base; Radiotherapy; Comparative study; Morbidity
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/jco.2000.18.1.35

To evaluate irradiation alone for treatment of base-of-tongue cancer.
Two hundred seventeen patients with squamous cell carcinoma of the base of tongue were treated with radiation alone and had follow-up for >/= 2 years.
Local control rates at 5 years were as follows: T1, 96%; T2, 91%; T3, 81%; and T4, 38%. Multivariate analysis revealed that T stage (P =.0001) and overall treatment time (P =.0006) significantly influenced local control. The 5-year rates of local-regional control were as follows: I, 100%; II, 100%; III, 83%; IVA, 64%; and IVB, 65%. Multivariate analysis revealed that the following parameters significantly affect the probability of this end point: T stage (P =.0001), overall treatment time (P =.0001), overall stage (P =.0131), and addition of a neck dissection (P =.0021). The rates of absolute and cause-specific survival at 5 years were as follows: I, 50% and 100%; II, 81% and 100%; III, 65% and 76%; IVA, 42% and 56%; and IVB, 44% and 52%. Severe radiation complications developed in eight patients (4%).
The likelihood of cure after external-beam irradiation was related to stage, overall treatment time, and addition of a planned neck dissection. The local-regional control rates and survival rates after radiation therapy were comparable to those after surgery, and the morbidity associated with irradiation was less.