Radiotherapy of locally advanced tumors of the mouth floor and the tongue

: At Istituto Radio "O. Alberti" in Brescia 312 patients with locally advanced cancers (T3-4N0 and T1-4N1-3) of the tongue or floor of the mouth were treated between 1970 and 1985. All underwent high energy radiotherapy associated, in 93 cases, with surgery on the T and/or on the N. The cases were divided by T and N in order to evaluate the prognostic importance of these parameters. Total remission (TR) at the end of treatment was achieved in 52% of the cases (163 patients). A relationship was found between tumor size, degree of lymph node involvement and the likelihood of response. Of the 163 cases in TR, 89 (55%) showed recurrence; 80% taking place within the first two years. After correction for natural death, the actuarial 5 year survival rate for the entire case study proved to be 27% while NED was 22%. The group undergoing radiotherapy in association with surgery showed a better survival rate than the group which only underwent radiotherapy (45% vs. 20% at 5 years). In the cases of advanced T (T3-4) lymph node involvement did not appear to affect prognosis.