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Combined cryosurgical, chemotherapeutic, and radiotherapeutic management of T1–4N0M0 oral cavity cancers
Author(s) -
Airoldi Mario,
Fazio Massimo,
Gandolfo Sergio,
Vercellino Vittorio,
Ozzello Franca,
Pedani Fulvia,
Camoletto Davide,
Negri Luciano
Publication year - 1985
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19850801)56:3<424::aid-cncr2820560303>3.0.co;2-v
Subject(s) - medicine , tongue , cheek , cryosurgery , cyclophosphamide , radiation therapy , surgery , methotrexate , lesion , chemotherapy , pathology
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 60 Co radiotherapy. The follow‐up period was at least 6 months (median, 50 months). Cryosurgery (1–2 sessions in 49 T1–2 cases; 2–4 in 35 T3–4 cases) was accompanied by a CMF (cyclophosphamide, methotrexate, 5‐fluorouracil) schedule (T1–2, two courses; T3–4, three courses). Radiotherapy was given 15 to 20 days after combined cryochemotherapy (T1, 50 Gy on tumor and lymph nodes; T2–3–4, same with an extra dose of 10 to 15 Gy 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 T1–2, 30 T3–4) with a follow‐up of more than 3 years was 59.6% for the series as a whole, 70.3% for T1–2, and 50.0% for T3–4; 78.2% for the tongue, 52.6% for the floor, 66.6% 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 T1–2, and 57.5% in T3–4 (tongue 86.9%, floor 56.1%, cheek 68.4%, 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.