Abstract
Purpose
To evaluate definitive external-beam radiotherapy (EBRT) for patients with base of the tongue (BOT) cancers.
Methods
We reviewed results for 26 patients with BOT cancers who were treated with EBRT. Clinical stages T1, T2, T3, and T4a were observed for 10, 7, 4, and 5 patients, respectively, and stages N0, N1, N2a, N2b, N2c, and N3 were observed for 4, 2, 5, 6, 8, and 1 patients, respectively. More than half of the patients (n = 19) were stage IVA. Standard total delivered doses were 70 Gy to primary tumors and cervical lymph node (CLN) metastases and 40–46 Gy to elective nodal regions. Eleven patients with advanced loco-regional disease received concurrent or neoadjuvant chemotherapy. Four T3 patients and one T2 patient received 2 or 3 cycles of concurrent intra-arterial cisplatin with EBRT (RADPLAT).
Results
Three-year overall survival was 69 % (95 % CI 47–83 %), with a median follow-up period of 33 months. Three-year local control was 100, 86, 100, and 20 % for T1, T2, T3, and T4 patients, respectively. Three-year regional control was 100 % for N0, N1, and N2a, 83 % for N2b, 75 % for N2c, and 0 % for N3 patients. Treatment failed for 7 patients. All 5 patients undergoing RADPLAT achieved complete responses and did not develop local recurrence.
Conclusions
We achieved favorable outcomes for patients with T1–T3 BOT cancers by use of definitive EBRT with or without chemotherapy.
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References
Osaka Prefectural Department of Public Health and Welfare, Osaka medical Association, Osaka Medical Center for Cancer and Cardiovascular Diseases. Annual Report of Osaka Cancer Registry No.76, Cancer Incidence and Medical Care in Osaka in 2008 and the Survival in 2006
Machtay M, Perch S, Markiewicz D et al (1997) Combined surgery and postoperative radiotherapy for carcinoma of the base of radiotherapy for carcinoma of the base of tongue: analysis of treatment outcome and prognostic value of margin status. Head Neck 19(6):494–499
Hinerman RW, Parsons JT, Mendenhall WM et al (1994) External beam irradiation alone or combined with neck dissection for base of tongue carcinoma: an alternative to primary surgery. Laryngoscope 104:1466–1470
Brunin F, Mosseri V, Jaulerry C et al (1999) Cancer of the base of the tongue: past and future. Head Neck 21:751–759
Al-Sarraf M, Pajak TF, Marcial VA et al (1987) Concurrent radiotherapy and chemotherapy with cisplatin in inoperable squamous cell carcinoma of the head and neck. An RTOG study. Cancer 59:259–265
Paccagnella A, Orlando A, Marchiori C et al (1994) Phase III trial of initial chemotherapy in stage III or IV head and neck cancers: a study by the Gruppo di Studio sui Tumori della Testa e del Collo. J Natl Cancer Inst 86:265–272
Merlano M, Benasso M, Corvo R et al (1996) Five-year update of a randomized trial of alternating radiotherapy and chemotherapy compared with radiotherapy alone in treatment of unresectable squamous cell carcinoma of the head and neck. J Natl Cancer Inst 88:583–589
Oikawa H, Nakamura R, Nakasato T et al (2009) Radiotherapy and concomitant intra-arterial docetaxel combined with systemic 5-fluorouracil and cisplatin for oropharyngeal cancer: a preliminary report–improvement of locoregional control of oropharyngeal cancer. Int J Radiat Oncol Biol Phys 75:338–342
Rabbani A, Hinerman RW, Schmalfuss IM et al (2007) Radiotherapy and concomitant intraarterial cisplatin (RADPLAT) for advanced squamous cell carcinomas of the head and neck. Am J Clin Oncol 30:283–286
Kano S, Homma A, Oridate N et al (2011) Superselective arterial cisplatin infusion with concomitant radiation therapy for base of tongue cancer. Oral Oncol 47:665–670
Rasch CR, Hauptmann M, Schornagel J et al (2010) Intra-arterial versus intravenous chemoradiation for advanced head and neck cancer: results of a randomized phase 3 trial. Cancer 116:2159–2165
Mendenhall WM, Morris CG, Amdur RJ et al (2006) Definitive radiotherapy for squamous cell carcinoma of the base of tongue. Am J Clin Oncol 29:32–39
Pederson AW, Haraf DJ, Witt ME et al (2010) Chemoradiotherapy for locoregionally advanced squamous cell carcinoma of the base of tongue. Head Neck 32:1519–1527
Denis F, Garaud P, Bardet E et al (2004) Final results of the 94-01 French Head and Neck Oncology and Radiotherapy Group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma. J Clin Oncol 22:69–76
Robbins KT, Kumar P, Harris J et al (2005) Supradose intra-arterial cisplatin and concurrent radiation therapy for the treatment of stage IV head and neck squamous cell carcinoma is feasible and efficacious in a multi-institutional setting: results of Radiation Therapy Oncology Group Trial 9615. J Clin Oncol 23:1447–1454
Olmi P, Crispino S, Fallai C et al (2003) Locoregionally advanced carcinoma of the oropharynx: conventional radiotherapy vs. accelerated hyperfractionated radiotherapy vs. concomitant radiotherapy and chemotherapy–a multicenter randomized trial. Int J Radiat Oncol Biol Phys 55:78–92
Nabil S, Samman N (2012) Risk factors for osteoradionecrosis after head and neck radiation: a systematic review. Oral Surg Oral Med Oral Pathol Oral Radiol 113:54–69
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Kawaguchi, Y., Nishiyama, K., Hirata, T. et al. Treatment outcomes of external-beam radiotherapy for squamous cell carcinoma of the base of the tongue. Int J Clin Oncol 20, 891–896 (2015). https://doi.org/10.1007/s10147-015-0805-8
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DOI: https://doi.org/10.1007/s10147-015-0805-8