Tzu Chi Medical Journal
Volume 21, Issue 1 , Pages 52-58, March 2009

Treatment Results and Prognostic Factors for Advanced Oral Tongue Cancer

  • Shih-Hsuan Hsiao

      Affiliations

    • Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • ,
  • Hon-Yi Lin

      Affiliations

    • Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • School of Medicine, Tzu Chi University, Hualien, Taiwan
    • ,
  • Moon-Sing Lee

      Affiliations

    • Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • School of Medicine, Tzu Chi University, Hualien, Taiwan
    • ,
  • Dian-Kun Li

      Affiliations

    • Department of Hematological Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • ,
  • Yu-Chieh Su

      Affiliations

    • Department of Hematological Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • ,
  • Ching-Chih Lee

      Affiliations

    • Department of Otolaryngology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • ,
  • Shih-Kai Hung

      Affiliations

    • Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, Chiayi, Taiwan
    • School of Medicine, Tzu Chi University, Hualien, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Radiation Oncology, Buddhist Dalin Tzu Chi General Hospital, 2, Ming-Sheng Road, Dalin, Chiayi, Taiwan

Received 7 March 2008; received in revised form 10 April 2008; accepted 27 April 2008.

Article Outline

Abstract 

Objective

The aim of this study was to retrospectively analyze advanced oral tongue cancer to determine tumor characteristics, treatment patterns and any other prognostic factors that may influence the survival of patients with the disease.

Patients and Methods

The records of 70 patients with stage III to IVA oral tongue cancer (TNM system) seen between December 1999 and December 2005 at one institution were reviewed. One group of patients had been treated with surgery plus adjuvant therapy (Group A), while the other group of patients had undergone definitive concurrent chemoradiotherapy (CCRT) without surgery (Group B). The chemotherapy protocol consisted of two month ly courses of cisplatin and fluorouracil as a concurrent regimen followed by another 2-month course as an adjuvant systemic regimen. The regimen was cisplatin (20 mg/m2/d) on day 1 and fluorouracil (1000 mg/m2/d) on days 1 to 5.

Results

The 3-year overall survival, disease-free survival, local recurrence and distant metastasis rates in Groups A/B were 76%/18%, 75%/22%, 14%/33% and 13%/27%, respectively. Significant differences were observed in the overall and disease-free survival in the two groups. Multivariate analysis for predictors of overall survival across all patients, treatment types and local recurrence were significant. Furthermore, multivariate analysis to discover predictors of overall survival showed that a positive pathological finding for the margin or a margin < 1 mm in size, and extracapsular spread were significant.

Conclusion

Among the patients who were not candidates for surgery, the effect of definitive CCRT was not satisfactory. A higher dose of radiation was found to result in significantly better survival and local control in Group A. However, in Group B, while local control was better with higher doses, survival did not differ significantly. The effectiveness of radiotherapy might be increased with the use of brachytherapy, the use of more effective drugs such as a radiosensitizer or other recently introduced chemotherapy drugs.

Keywords:  Concurrent chemoradiation , Oral tongue cancer , Prognostic factors , Surgery

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PII: S1016-3190(09)60008-2

doi:10.1016/S1016-3190(09)60008-2

Tzu Chi Medical Journal
Volume 21, Issue 1 , Pages 52-58, March 2009

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