Treatment of cancer of the base of the tongue and glosso-epiglottic region: A multicenter Italian survey

Background: The current treatment options for cancer of the base of the ton gue and glosso-epiglottic region are surgery, radiotherapy, or a combinatio n of both modalities. Comparisons between different modalities are not comm on in the literature, and a real standard of treatment has not yet been est ablished. The purpose of our study was to evaluate the results of treatment in a large series of patients from 18 Italian institutions in relation to the main treatment adopted. Methods: The present study is a retrospective survey. The series was divide d into a combined surgery group and a radiotherapy group. The Kaplan-Meier method and the log-rank test were used for survival calculations and compar isons. Results: Eight hundred patients were registered (25.7% stage III and 62% st age IV), 336 in the surgery and 372 in the radiotherapy group. Conventional fractionation was adopted in almost all cases. The five-year overall and d isease free survival of the whole series was 32% and 38%, respectively. Sur vival was slightly better for patients with tumors of the glosso-epiglottic region than for those with a tumor of the base of the tongue. Five-year di sease-free survival was 55% for patients treated with surgery +/- radiochem otherapy and 26% for those submitted to radiotherapy alone or in combinatio n with chemotherapy. As far as the total dose and the treatment duration we re concerned, only 26% of the patients of the radiotherapy group met the es tablished criteria of adequacy, but in patients with adequate radiation the control rate was better only for small tumors (T1-T2). Conclusions: The results in patients treated with surgery +/- postoperative radiotherapy were similar to or better than those reported in the best ser ies in the literature. By contrast, the survival rate of irradiated patient s was lower than those reported by other centers.