For persons who have cancer of the base of the tongue, treatment usually includes radiation therapy or surgery. Other options include radiation therapy used before surgery, or chemotherapy used after surgery. When surgery is used, it must be quite extensive to cure this type of cancer, often resulting in some disfigurement of the face and/or neck as well as other side effects. Therefore, researchers have been conducting studies to determine which treatments offer the most effectiveness with the least disfigurement and side effects. Researchers in Florida are now reporting favorable results using radiation therapy following surgical removal of any affected lymph nodes in the neck.
Doctors at the University of Florida treated 217 persons with early-stage (stages I and II), intermediate stage (stage III), or late stage (stage IV) cancer of the base of the tongue. The patients underwent a planned neck dissection, that is a surgery to remove the lymph nodes that showed signs and symptoms of cancer. They then underwent external-beam radiation therapy, the use of high-energy rays delivered by a machine to the body. In those with stage I and II disease, local control of the cancer was achieved in all patients; the 5-year survival rate was 80%. In those with stage III cancer, local control of cancer was achieved in 83%, and the 5-year survival rate was 75%. In those with stage IV disease, local control of the cancer was achieved in 65%, with 45% surviving 5 years. The planned lymph node dissection procedure appeared to improve survival time.
The results found with external-beam radiation therapy for cancer at the base of the neck were related to stage of disease, the overall time of the treatment, and the addition of the planned neck dissection procedure. The findings regarding control rates and survival time are comparable to those with surgery. Since surgery usually produces more disfigurement and more side effects than radiation therapy, radiation therapy may be the treatment of choice for persons with cancer of the base of the tongue. (
Journal of Clinical Oncology, Vol 18, No 1, pp 35-42, 2000)