title: Primary radiotherapy for carcinoma of the retromolar trigone: a useful alternative to surgery.
abstract: OBJECTIVE
  Squamous cell carcinoma of the retromolar trigone is uncommon. The standard initial treatment is primary surgery, which usually involves microvascular reconstruction with a composite flap. Some patients are considered unsuitable for this procedure. This retrospective study examined the outcome and toxicity for patients with squamous cell carcinoma of the retromolar trigone treated with definitive radiotherapy in a single centre.
  
  
  METHODS
  Between 1991 and 2000, 43 patients were treated with definitive radiotherapy with a median dose of 50Gy in 16 fractions over 21 days. Hospital case notes and radiotherapy records were analysed.
  
  
  RESULTS
  The median age was 66 years (range 39-84 years). Nodal disease was evident in 13 (30.2%) patients. Twenty-one patients (51.2%) had stage I/II disease and 20 patients (48.8%) had stage III/IV disease. After a median follow-up of 59 months, 13 (30.2%) patients were alive and well, nine (20.9%) patients had died of an intercurrent illness and 21 (48.8%) had died of their disease. Five-year locoregional control was 46.5% (95% confidence interval 29.7-61.7), cause-specific survival was 45.7% (95% confidence interval 29.1-60.8) and overall survival was 30.9% (95% confidence interval 17.5-46.3). Osteoradionecrosis was documented in two patients.
  
  
  CONCLUSIONS
  This hypofractionated regimen is convenient for this patient population and produced comparable outcomes to longer fractionation schedules without an increase in late toxicity.
authors: Department of Clinical Oncology, The Christie NHS Foundation Trust, Manchester, UK. neil.bayman@christie.nhs.uk
authors: N A
authors: NA
authors: Bayman
authors: A J
authors: AJ
authors: Sykes
authors: S
authors: S
authors: Bonington
authors: T
authors: T
authors: Blackburn
authors: M
authors: M
authors: Patel
authors: R
authors: R
authors: Swindell
authors: N J
authors: NJ
authors: Slevin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D005260:Female; D005500:Follow-Up Studies; D005720:Gamma Rays; D006801:Humans; D007822:Laryngeal Neoplasms / Q000209:etiology*; D008175:Lung Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D009367:Neoplasm Staging; D009381:Neoplasms, Radiation-Induced / Q000209:etiology*; D016609:Neoplasms, Second Primary / Q000209:etiology*; D010025:Osteoradionecrosis / Q000209:etiology; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome