Management of squamous cell carcinoma of the base of tongue with chemoradiation and brachytherapy

Head Neck. 2009 Nov;31(11):1431-8. doi: 10.1002/hed.21111.

Abstract

Background: Treatment of base of tongue (BOT) squamous cell carcinoma (SCC) has traditionally been associated with poor prognosis and significant morbidity. We report a program consisting of concurrent chemoradiation followed by brachytherapy for these patients.

Methods: We reviewed all patients in our institution with previously untreated BOT SCC (1996-2004) who received this treatment program.

Results: In 88 patients (median age, 60.2 years; 37 T1/T2; 51 T3/T4), cervical lymph node metastases were present in 71 patients (80.7%). Six patients had residual/subsequent cervical metastases requiring 7 neck dissections. Local recurrence occurred in 16 patients (18.2%) and distant metastases occurred in 9 patients (10.2%). Median follow-up time was 3.1 years (range, 0.5-7.8 years). Three-year overall survival was 80.9% (95% CI: 69.6% to 88.3%). Locoregional control rate was 79.9% and disease-specific survival was 69.5% at 3 years.

Conclusions: Concurrent chemoradiotherapy followed with brachytherapy is a safe and effective method of treatment of SCC of the BOT.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / administration & dosage*
  • Brachytherapy*
  • Carboplatin / administration & dosage
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Chemotherapy, Adjuvant
  • Cisplatin / administration & dosage
  • Cohort Studies
  • Disease-Free Survival
  • Female
  • Fluorouracil / administration & dosage
  • Humans
  • Male
  • Middle Aged
  • Paclitaxel / administration & dosage
  • Radiation-Sensitizing Agents / administration & dosage*
  • Retrospective Studies
  • Tongue Neoplasms / mortality
  • Tongue Neoplasms / pathology
  • Tongue Neoplasms / therapy*
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Radiation-Sensitizing Agents
  • Carboplatin
  • Paclitaxel
  • Cisplatin
  • Fluorouracil