Radiotherapy alone or combined with chemotherapy for base of tongue squamous cell carcinoma
Kaitlin Christopherson MD
Department of Radiation Oncology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorChristopher G. Morris MS
Department of Radiation Oncology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorJessica M. Kirwan MA
Department of Radiation Oncology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorRobert J. Amdur MD
Department of Otolaryngology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorPeter T. Dziegielewski MD
Department of Otolaryngology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorBrian J. Boyce MD
Department of Otolaryngology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorCorresponding Author
William M. Mendenhall MD
Department of Radiation Oncology, University of Florida, Gainesville, Florida, U.S.A
Send correspondence to William M. Mendenhall, MD, 2000 SW Archer Road, PO Box 100385, Gainesville, FL 32610-0385. E-mail: [email protected]Search for more papers by this authorKaitlin Christopherson MD
Department of Radiation Oncology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorChristopher G. Morris MS
Department of Radiation Oncology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorJessica M. Kirwan MA
Department of Radiation Oncology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorRobert J. Amdur MD
Department of Otolaryngology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorPeter T. Dziegielewski MD
Department of Otolaryngology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorBrian J. Boyce MD
Department of Otolaryngology, University of Florida, Gainesville, Florida, U.S.A
Search for more papers by this authorCorresponding Author
William M. Mendenhall MD
Department of Radiation Oncology, University of Florida, Gainesville, Florida, U.S.A
Send correspondence to William M. Mendenhall, MD, 2000 SW Archer Road, PO Box 100385, Gainesville, FL 32610-0385. E-mail: [email protected]Search for more papers by this authorThe authors have no funding, financial relationships, or conflicts of interest to disclose.
Abstract
Objectives/Hypothesis
To evaluate the long-term disease control, survival, and complications after definitive radiotherapy (RT) alone or combined with adjuvant chemotherapy with or without planned neck dissection for base of tongue squamous cell carcinoma (SCC).
Study Design
We retrospectively reviewed the medical records of 467 patients treated at the University of Florida with definitive RT alone or combined with adjuvant chemotherapy between 1964 and 2011 for base of tongue SCC.
Methods
Median follow-up was 5.6 years. Median total dose to the primary site was 74.4 Gy. Eighty-seven patients (19%) were treated with once-daily fractionation, and 380 (81%) received altered fractionation schedules. Intensity-modulated RT was used in 128 patients (27%). Chemotherapy was administered to 173 (37%) patients. Planned neck dissection after RT was performed in 226 patients (48%). Data regarding p16 pathway activation were available for 25 patients.
Results
At 5 years, the local, local–regional, and regional control rates were 85.5%, 80.0%, and 90.0%, respectively. The 5-year overall, cause-specific, and distant metastasis-free survival rates were 59.1%, 71.5%, and 84.1%, respectively. Sixty-four patients (14%) developed one or more severe late complications. Fifty patients (11%) required late gastrostomy tube placement.
Conclusions
This study supports the continued use of RT alone or combined with adjuvant chemotherapy for patients with base of tongue SCC, as this treatment yields high rates of cause-specific survival and disease control, with a relatively low rate of late complications.
Level of Evidence
4. Laryngoscope, 127:1589–1594, 2017
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