OBJECTIVE

To investigate relapse-free survival (RFS) for various special treatment options for certain localizations of mucosa of the oral cancer (OC) (tongue, floor of the mouth, cheek, lower jaw, and lip), by using modern 3D conformal radiotherapy (3D-CRT).

Subjects and methods. Among 100 patients treated at the Center for squamous cell carcinoma of the oral mucosa, 40 patients received modern 3D-CRT using fractionation with 2-3 Gy/fraction to a total dose equivalent (eq.) to 50 Gy (Group 1). Forty patients had radical organ-sparing combined 3D-CRT (2-3 Gy/fraction) to a total dose eq. to 46 Gy, followed by brachytherapy (BT) with a high radiation dose rate of a total dose eq. to 30 Gy, with a resulting total dose for the primary tumor in two stages of radiation therapy eq. to 76 Gy (Group 2). Twenty patients received 3D-CRT (2-3 Gy/fraction) for the entire tumor volume and lymph collectors up to a total dose eq. to 46 Gy, followed by exposure of the residual primary tumor to photodynamic therapy (PDT) and laser intensive thermotherapy (LITT) with contraindications to BT (Group 3). The patients’ mean age was 59.2 years (age range 26—90 years) with a male preponderance (55%) in the patients in all the groups.

RESULTS

Five-year RFS amounted to as much as 73.3% for all the 100 patients. It was 73.3% in the combined treatment group, 78% in the 3D-CRT + BT group, and 61.1% in the 3D-CRT + PDT and LITT group. In Stage I—II OC, 5-year RFS was 75.9%; in locally advanced (Stage III—IVA) cancer, it decreased to 67.9% without statistical significance (p=0.507).

CONCLUSION

In the multicomponent treatment of OC in patients having contraindications to surgery within the organ-sparing option, the use of modern 3D-CRT for the entire tumor volume and lymphatic collectors in combination with BT or PDT with LITT can be considered as an alternative combined treatment option.