title: Treatment of squamous cell carcinoma of the mobile tongue or tongue margins: an interdisciplinary challenge.
abstract: BACKGROUND
  Standard treatment is surgery with stage dependent postoperative radio(chemo)therapy, however, for organ preservation preoperative radio(chemo)therapy is used as an individual approach. The present analysis was performed to access outcome and toxicity of radiotherapeutical treatment of squamous cell carcinoma of the tongue.
  
  
  METHODS
  Sixty-six patients (median age 55 years) with cancer of the mobile tongue (n=30) or tongue margins (n=36) treated between 1982 and 2006 were retrospectively analyzed. Treatment consisted of definitive- (n=13, median dose 66 Gy), adjuvant- (n=31, median dose 60 Gy) or neoadjuvant radiotherapy (n=22, median dose 40 Gy) and chemotherapy (n=34) or immunotherapy (n=1).
  
  
  RESULTS
  After a median follow-up of 29 months the three- and five-year overall survival (OS) rates were 59% and 46%, respectively. The median OS was 54 months. Forty-two patients achieved complete remission whereas 14 patients showed partial remission. The one- and two-year loco-regional progression-free survival (LRPFS) rates were 76% and 58%, respectively. The median LRPFS time was 36 months. In χ(2)-test, T-stage showed a trend towards impact on local recurrence (Pearson, p=0.082). In multivariate analysis, alcohol consumption (p=0.003) and gender (p=0.031) were prognostic. Grade III/IV acute toxicity was seen in 52% of patients. None of the locally controlled patients reported grade IV or higher late toxicity.
  
  
  CONCLUSIONS
  No statistically significant differences between treatment modalities were found, but one should keep in mind that organ preservation plays a major role for quality of life. None of the locally controlled patients reported grade IV or higher late toxicity. However, tumor recurrence is common, especially in advanced tumor stage. Interdisciplinary concepts, further increasing the chance of tumor control are warranted.
authors.affiliation: Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany. Henrik.Hauswald@med.uni-heidelberg.de
authors.forename: Henrik
authors.initials: H
authors.lastname: Hauswald
authors.forename: Felix
authors.initials: F
authors.lastname: Zwicker
authors.forename: Nathalie
authors.initials: N
authors.lastname: Rochet
authors.forename: Alexandra D
authors.initials: AD
authors.lastname: Jensen
authors.forename: Juergen
authors.initials: J
authors.lastname: Debus
authors.forename: Katja
authors.initials: K
authors.lastname: Lindel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D014062:Tongue Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D016896:Treatment Outcome