title: Can Superselective Intra-Arterial Chemoradiotherapy Replace Surgery Followed by Radiation for Advanced Cancer of the Tongue and Floor of the Mouth?
abstract: OBJECTIVE
  The purpose of this study was to compare quality of life (QoL) and the survival rate after surgery with and without radiotherapy versus superselective intra-arterial chemoradiotherapy (SSIACRT) for advanced cancer of the tongue and floor of the mouth.
  
  
  METHODS
  Patients with stage III and IV squamous cell carcinoma of the tongue and floor of the mouth treated between 2000 and 2013 were included in this study. The predictor variables were surgery without radiotherapy, surgery followed by radiotherapy, and SSIACRT. The outcome variables were QoL and the survival rate. The University of Washington QoL questionnaire (UW-QOL) was used for evaluation of QoL. The Kaplan-Meier method was used to estimate the overall survival rate. The UW-QOL was analyzed by analysis of covariance, and the survival rate was analyzed statistically by the log-rank test.
  
  
  RESULTS
  Sixty-two patients were eligible for this study. Of these, 13 were treated by surgery without radiotherapy, 29 were treated by surgery plus radiotherapy, and 20 were treated by SSIACRT. The SSIACRT group had the best UW-QOL scores among the 3 groups. The 5-year Kaplan-Meier disease-specific survival rates for these groups were 92.9%, 62.9%, and 83.2%, respectively, with no significant difference (P = .20) shown.
  
  
  CONCLUSIONS
  The QoL scores of the SSIACRT group were the best among the 3 groups in most domains. The superiority of QoL and the survival rate in the SSIACRT group showed that SSIACRT should be preferred in managing advanced cancer of the tongue and floor of the mouth.
authors: Professor, Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. Electronic address: wako@hirosaki-u.ac.jp.
authors: Wataru
authors: W
authors: Kobayashi
authors: Assistant Professor, Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Kosei
authors: K
authors: Kukobota
authors: Resident, Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Ryohei
authors: R
authors: Ito
authors: Assistant Professor, Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Hirotaka
authors: H
authors: Sakaki
authors: Research Associate, Department of Oral and Maxillofacial Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.
authors: Hirosi
authors: H
authors: Nakagawa
authors: Department Head, Department of Oral and Maxillofacial Surgery, Misawa City Hospital, Misawa, Japan.
authors: Beng Gwan
authors: BG
authors: Teh
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000628:therapy*; D059248:Chemoradiotherapy / Q000379:methods; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009060:Mouth Floor; D009062:Mouth Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D016019:Survival Analysis; D014062:Tongue Neoplasms / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*