Carcinoma of the oral tongue: a comparison of results and complications of treatment with radiotherapy and/or surgery.
BACKGROUND
Oral tongue cancer may be treated primarily with radiotherapy or with surgery alone or combined with adjuvant radiotherapy; the choice between these two approaches is controversial.


METHODS
To evaluate the results of a shift in treatment policy in 1985 in favor of primary surgical treatment for carcinoma of the oral tongue, the results of radiotherapy (with or without neck dissection, 105 patients) were compared with those for surgery (with or without radiotherapy, 65 patients).


RESULTS
Local control rates were improved for T3 (p = .03) and 14 (p = .08) patients treated surgically but were similar for T1-T2 patients. Local-regional control and survival rates were not significantly different. The rate of severe complications was significantly higher (p = .01) for T3 patients treated with surgery, particularly in the subset of patients who received postoperative radiotherapy.


CONCLUSIONS
We generally recommend surgical treatment for T1-T2 patients with the addition of postoperative twice-a-day radiotherapy in selected cases. For selected T3-T4 patients we are investigating split-course twice-a-day preoperative radiotherapy in the hope that the extent of the surgical procedure, and hence the rate of severe complications, will be reduced.
Fein
D A
DA
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville.
Mendenhall
W M
WM
Parsons
J T
JT
McCarty
P J
PJ
Stringer
S P
SP
Million
R R
RR
Cassisi
N J
NJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001918:Brachytherapy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000556:secondary / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D011183:Postoperative Complications; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D011882:Radiotherapy, High-Energy; D015996:Survival Rate; D014062:Tongue Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery*; D016896:Treatment Outcome