CARCINOMA OF THE ORAL TONGUE - A COMPARISON OF RESULTS AND COMPLICATIONS OF TREATMENT WITH RADIOTHERAPY AND OR SURGERY

Background. Oral tongue cancer may be treated primarily with radiother apy or with surgery alone or combined with adjuvant radiotherapy; the choice between these two approaches is controversial. Methods. To eval uate the results of a shift in treatment policy in 1985 in favor of pr imary surgical treatment for carcinoma of the oral tongue, the results of radiotherapy (with or without neck dissection, 105 patients) were compared with those for surgery (with or without radiotherapy, 65 pati ents). Results. Local control rates were improved for T3 (p = .03) and T4 (p = .08) patients treated surgically but were similar for T1-T2 p atients. Local-regional control and survival rates were not significan tly different. The rate of severe complications was significantly high er (p = .01) for T3 patients treated with surgery, particularly in the subset of patients who received postoperative radiotherapy. Conclusio ns. We generally recommend surgical treatment for T1-T2 patients with the addition of postoperative twice-a-day radiotherapy in selected cas es. For selected T3-T4 patients we are investigating split-course twic e-a-day preoperative radiotherapy in the hope that the extent of the s urgical procedure, and hence the rate of severe complications, will be reduced. (C) 1994 John Wiley & Sons, Inc.