Squamous cell carcinomas of the soft palate treated with radiation therapyalone or followed by planned neck dissection

Purpose: The present study presents the experience at the University of Flo rida with treatment of unselected patients with carcinomas of the soft pala te with radiation therapy (RT) alone or followed by planned neck dissection . Methods and Materials: One hundred seven patients treated with curative int ent with RT alone or followed by neck dissection from 1965 to 1996 were inc luded in the study. All patients had follow-up for at least 2 years. No pat ients were lost to follow-up. Results: Local control rates at 5 years were 86% for T1, 91% for T2, 67% fo r T3, and 36% for T4 carcinomas. T-stage and overall treatment time signifi cantly affected local control in multivariate analysis. Nodal control rates at 5 years were 86% for NO, 76% for N1, 61% for N2, and 67% for N3 carcino mas. Overall treatment time and planned neck dissection significantly affec ted nodal control in multivariate analysis. Ultimate local-regional control rates at 5 years were 90% for Stage I, 92% for Stage II, 84% for Stage III , and 60% for Stage IV disease. Overall treatment time and planned neck dis section significantly affected ultimate local-regional control in multivari ate analysis. The overall survival rate at 5 years was 42% for all patients . Overall stage; overall treatment time, and planned neck dissection signif icantly affected overall survival in multivariate analysis. The cause-speci fic survival rate at 5 years was 70% for all patients. Overall treatment ti me and planned neck dissection significantly affected cause-specific surviv al in multivariate analysis. Three patients sustained severe postoperative complications and 3 patients sustained severe late complications. Sixteen p atients had synchronous and 14 patients had metachronous carcinomas of the head and neck mucosal sites. Conclusion: For limited carcinomas of the soft palate, RT (alone or followe d by planned neck dissection) results in relatively high local-regional con trol and survival rates. For advanced carcinomas of the soft palate, local- regional control and survival rates are relatively low and local-regional r ecurrence rates are substantial. Advanced carcinomas of the soft palate may be better treated with RT and concomitant chemotherapy. (C) 2001 Elsevier Science Inc.