Radiotherapy alone or combined with chemotherapy for the treatment of squamous cell carcinoma of the base of the tongue.

OBJECTIVES

To evaluate the efficacy of definitive radiotherapy (RT) for the treatment of base of the tongue cancer in a private practice.

METHODS

We retrospectively reviewed the medical records of 48 patients with squamous cell carcinoma of the base of the tongue treated with definitive RT and followed from 0.2 to 15.2 years (median, 2.7 y). Follow-up of living patients ranged from 1.5 to 15.2 years (median, 4.9 y). Two thirds of the patients received twice-daily treatment. The median total dose was 74.4 Gy (range, 65 to 76.8 Gy). The median overall treatment time was 45.5 days (range, 36 to 68 d). There were 3 patients (6%) with clinically positive neck nodes who received a neck dissection. Adjuvant chemotherapy was given to 28 patients (58%) with advanced local-regional disease; 1 patient (4%) received induction chemotherapy and 27 patients (96%) received concomitant chemotherapy. Toxicity was graded according to the Common Terminology Criteria for Adverse Events, v3.0.

RESULTS

Local control rates by T stage at 5 years were as follows: T1 to T2, 91%; T3, 83%; and T4, 12%. The 5-year rates of local-regional control were as follows: I to II 80%; III, 89%; IVA, 59%; and IVB, 42%. The rates of overall survival at 5 years were as follows: I to II, 67%; III, 56%; IVA, 45%; and IVB, 33%. The 5-year rates of cause-specific survival were as follows: I to II, 67%; III, 76%; IVA, 50%; and IVB, 60%. Seven patients (15%) experienced severe late complications.

CONCLUSIONS

Our data reveal that the local-regional control and overall survival rates after definitive RT were comparable with those in the literature. Twice-daily radiation is well tolerated with moderate-late toxicity, which is consistent with the observations of others.