Background: Treatment options for locally advanced tongue squamocellular carcinoma (SCC) include surgery alone, radiotherapy alone, or multimodality treatment. These highly aggressive tumors are best treated by partial glossectomy in order to save organ function and postoperative radiotherapy (RT). When positive margins and/or extracapsular nodal extension are found, postoperative hemoradiotherapy (CRT) is warranted. We report on our experience with this approach. Methods: A total of 20 patients (pts) with primary tongue SCC were treated with surgery and postoperative RT. All pts underwent partial, hemi-, or subtotal glossectomy; 16 pts (80%) underwent ipsilateral radical or modified radical neck dissection. Ten pts received postoperative RT alone (median dose 6000 cGy) while 10 pts received postoperative CRT consisting of RT and Cisplatin 100 mg/m2 days 1-22- 43. Stage distribution was as follows: stage III, 5; stage IV, 15. Median follow-up is 23 months. Results: For the entire group of pts, the actuarial 2-year locoregional control rate was 80%; the same rate was recorded for both stage III and IV disease. The actuarial 2-year overall survival rate was 70%. There was one local failure among 10 pts with negative margins (local control 95%) and 3 among pts with positive margins (local control 85%). Four pts developed distant metastases, 2 with negative and 2 with positive margins. Postoperative treatment was well tolerated. Three pts treated by RT and 4 pts treated by CRT experienced grade 3 oral mucositis. Late major complications of RT and CRT included 3/20 pts requiring permanent G-tubes and/or tracheostomy to prevent aspiration. Conclusions: Surgery plus postoperative RT is an intensive treatment for SCC of the tongue which offers high locoregional control rate in patients with negative margins. Postoperative CRT can be safely administered to pts with positive margins and/or extracapsular nodal extension achieving satisfactory results in terms of both locoregional control and distant failure.

COMBINED SURGERY AND POST-OPERATIVE RADIOTHERAPY OR CHEMORADIOTHERAPY FOR LOCALLY ADVANCED TONGUE CANCER / C. Codecà, F. Chiesa, L. Calabrese, B. Jereczek-Fossa, A. Maccari, G. Felisati, J. Fiore, S. Oldani, D. Ferrari, P. Foa. - In: ANNALS OF ONCOLOGY. - ISSN 0923-7534. - 18 suppl. 11(2007), pp. xi57-xi58. ((Intervento presentato al 9. convegno National Congress of Medical Oncology tenutosi a Palermo nel 2007.

COMBINED SURGERY AND POST-OPERATIVE RADIOTHERAPY OR CHEMORADIOTHERAPY FOR LOCALLY ADVANCED TONGUE CANCER

C. Codecà;B. Jereczek-Fossa;G. Felisati;P. Foa
2007

Abstract

Background: Treatment options for locally advanced tongue squamocellular carcinoma (SCC) include surgery alone, radiotherapy alone, or multimodality treatment. These highly aggressive tumors are best treated by partial glossectomy in order to save organ function and postoperative radiotherapy (RT). When positive margins and/or extracapsular nodal extension are found, postoperative hemoradiotherapy (CRT) is warranted. We report on our experience with this approach. Methods: A total of 20 patients (pts) with primary tongue SCC were treated with surgery and postoperative RT. All pts underwent partial, hemi-, or subtotal glossectomy; 16 pts (80%) underwent ipsilateral radical or modified radical neck dissection. Ten pts received postoperative RT alone (median dose 6000 cGy) while 10 pts received postoperative CRT consisting of RT and Cisplatin 100 mg/m2 days 1-22- 43. Stage distribution was as follows: stage III, 5; stage IV, 15. Median follow-up is 23 months. Results: For the entire group of pts, the actuarial 2-year locoregional control rate was 80%; the same rate was recorded for both stage III and IV disease. The actuarial 2-year overall survival rate was 70%. There was one local failure among 10 pts with negative margins (local control 95%) and 3 among pts with positive margins (local control 85%). Four pts developed distant metastases, 2 with negative and 2 with positive margins. Postoperative treatment was well tolerated. Three pts treated by RT and 4 pts treated by CRT experienced grade 3 oral mucositis. Late major complications of RT and CRT included 3/20 pts requiring permanent G-tubes and/or tracheostomy to prevent aspiration. Conclusions: Surgery plus postoperative RT is an intensive treatment for SCC of the tongue which offers high locoregional control rate in patients with negative margins. Postoperative CRT can be safely administered to pts with positive margins and/or extracapsular nodal extension achieving satisfactory results in terms of both locoregional control and distant failure.
Settore MED/31 - Otorinolaringoiatria
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2434/191734
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