Combined cryosurgical, chemotherapeutic, and radiotherapeutic management of T1–4N0M0 oral cavity cancers
✍ Scribed by Mario Airoldi; Massimo Fazio; Sergio Gandolfo; Vittorio Vercellino; Franca Ozzello; Fulvia Pedani; Davide Camoletto; Luciano Negri
- Publisher
- John Wiley and Sons
- Year
- 1985
- Tongue
- English
- Weight
- 589 KB
- Volume
- 56
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
Eighty-four previously untreated patients (69 males, 15 females) with squamous carcinoma of the tongue (30 patients), floor of the mouth (30), cheek ( 16), and retromolar region (8) were treated using a protocol comprising cryosurgery + chemotherapy, followed by external 6oCo radiotherapy. The follow-up period was at least 6 months (median, 50 months). Cryosurgery (1-2 sessions in 49 TI-2 cases; 2-4 in 35 T3-4 cases) was accompanied by a C M F (cyclophosphamide, methotrexate, 5fluorouracil) schedule (TI-2, two courses; T3-4, three courses). Radiotherapy was given 15 to 20 days after combined cryochemotherapy (TI, 50 Gy on tumor and lymph nodes; T2-3-4, same with an extra dose of 10 to 15 Cy on the primary lesion). Complete remission was reached 4 months after treatment in 76 of 84 patients (90.5%). Survival with no evidence of disease (NED) in the 57 patients (27 TI-2, 30 T3-4) with a follow-up of more than 3 years was 59.6% for the series as a whole, 703% for TI-2, and 50.0% for T34, 78.2% for the tongue, 52.6% for the floor, &.6% for the cheek, and 0% for the retromolar region. The picture was much the same after 5 years. Actuarial survival at 6 years was 66% in the series as a whole, 75.5% in TI-2, and 57.5% in T3-4 (tongue 86.9%, floor 56.1%, cheek 68.496, and retromolar region 0%). It is believed that the results obtained in tumors of the tongue, floor and cheek, coupled with the conservative aspects of the protocol, make it a suitable subject for a controlled trial.
Cancer W424-431. 1985.
ARIOUS MODALITIES have been tried in recent years
V in an attempt to improve the treatment of squamous cancer of the oral cavity. New surgical methods,' combinations of radiotherapy and surgery,* and adjuvant chemotherapy and irnmun~therapy,~.~ have been experimented in early (Stage 1-11) cases. These approaches do not appear to give better results than radiotherapy or surgery a l ~n e . ~.