Concurrent platinum-based chemotherapy and simultaneous modulated accelerated radiation therapy for locally advanced squamous cell carcinoma of the tongue base.
BACKGROUND
Randomized data support use of chemotherapy concurrently with radiation in treatment of advanced squamous cell carcinoma (SCC) of the oropharynx. Intensity modulated radiation therapy (IMRT) is increasingly being used to deliver such radiotherapy; no published reports specifically describe results of chemotherapy with IMRT for SCC of the base of tongue (BOT). We present outcomes data using simultaneous modulated accelerated radiation therapy (SMART) combined with platinum-based chemotherapy in treatment of locally advanced SCC of the BOT METHODS: The records of the Otolaryngology/Head and Neck Surgery Department of Emory University were screened for patients undergoing definitive chemoradiotherapy for SCC of the BOT. Radiation Oncology records were reviewed for dosimetry and prescription data. Hospital and clinic records were reviewed for control and toxicity data. All patients were treated definitively with platinum-based chemotherapy and once-daily RT. Median dose and dose per fraction to sites of gross primary or nodal disease, clinically involved neck, and clinically uninvolved neck were 70.29 Gy (2.13 Gy/fx), 63.03 Gy (1.91 Gy/fx), and 57.75 Gy (1.75 Gy/fx), respectively.


RESULTS
Between January 2003 and August 2005, 34 patients underwent definitive therapy for SCC of the BOT using SMART and chemotherapy. Follow-up was documented in all cases (median, 20.1 months). There have been 3 distant failures and 3 locoregional failures.


CONCLUSIONS
With moderate follow-up, chemotherapy and SMART contributes to excellent results, with 24-month actuarial overall survival and local control of 90% and 92%, respectively. Toxicity may be increased, however, with 15% of patients developing esophageal stricture or stenosis. .
Department of Radiation Oncology, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Joshua D
JD
Lawson
Kristen
K
Otto
Amy
A
Chen
Dong M
DM
Shin
Lawrence
L
Davis
Peter A S
PA
Johnstone
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D016190:Carboplatin / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005774:Gastrostomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D017239:Paclitaxel / Q000627:therapeutic use; D011879:Radiotherapy Dosage; D014062:Tongue Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*
D000970:Antineoplastic Agents; D016190:Carboplatin; D017239:Paclitaxel; D002945:Cisplatin