Can Superselective Intra-arterial Chemoradiotherapy replace surgery followed by radiation for advanced cancer of tongue and floor of mouth?

Publication date: Available online 8 January 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Wataru Kobayashi, Kosei Kukobota, Ryohei Ito, Hirotaka Sakaki, Hirosi Nakagawa, Beng Gwan Teh
PurposeThe purpose of this study was to compare quality of life (QoL) and 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.Materials and MethodsPatients with stage III and IV squamous cell carcinoma (SCC) of the tongue and floor of the mouth treated between 2000 and 2013 were included in this study. Predictor variables were surgery without radiotherapy (S), surgery followed by radiotherapy (S+R), and SSIACRT. Outcome variables were QoL and survival rate. The University of Washington QoL questionnaire (UWQoL) was used for evaluation of QoL. Kaplan-Meier method was used to estimate the overall survival rate. UWQoL was analyzed by analysis of covariance and survival rate was analyzed by log-rank test statistically.ResultsSixty-two patients were eligible for this study. Thirteen patients were treated by S, 29 patients were treated by S+R, and 20 patients were treated by SSIACRT. SSIACRT had the best UWQoL scores among the three groups. The 5-year Kaplan-Meier disease-specific survival rate for these groups were 92.9, 62.9, and 83.2%, respectively, with no significant difference (p=0.20) revealed.ConclusionsThe QoL scores of SSIACRT were the best among the three groups in most domains. The superiority of QoL and survival rate in SSIACRT demonstrated that SSIACRT should be preferred in managing advanced cancer of the tongue and floor of the mouth. Introduction

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