The role of radical surgery and post-operative radiotherapy in the management of intra-oral carcinoma.
The incidence rate for carcinoma of the tongue and floor of mouth has fallen in Scotland over the past 20 years (Fig. 1). Despite the fall in incidence rate and mortality rate many such tumours present late when the prognosis is poor (Pointon and Gleave, 1982; Decroix and Ghossein, 1981a; Shaw 1982). Until relatively recently most centres treated such lesions either by surgery or by radiotherapy alone. Over the past decade a number of centres have adopted a dual treatment policy involving both surgery and radiotherapy. The head and neck oncologists at the Royal Marsden advocate pre-operative radiotherapy (Shaw, 1982) while Glasgow and the Memorial in New York (Vikram et al., 1980) have adopted the practice of post-operative radiotherapy. A combined plastic surgery/radiotherapy clinic has been run in Glasgow for the past ten years and over that time a treatment protocol has evolved. The results of treatment of all advanced tumours of the tongue and floor of mouth referred to the Glasgow Institute of Radiotherapeutics and Oncology are presented here. The results of planned combined therapy-radical surgery followed by radical radiotherapy--are compared with the results of treating similar lesions by minimal surgery plus radical radiotherapy and the advantages of combined radical treatment are discussed.
D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009060:Mouth Floor; D009062:Mouth Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D014062:Tongue Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*