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• W2413601906 abstract "Base of tongue cancers require complex, multidisciplinary evaluation because they present in advanced stage due to their relatively occult location, insidious growth pattern and predisposition for lymphatic spread. Early stage tumors can be treated effectively with primary surgery or external beam radiation therapy (EBRT), while advanced tumors require multimodality therapy. Since equivalent tumor control can be achieved, the management of base of tongue cancer has evolved toward primary radiation therapy over definitive surgical management because of organ preservation and better functional/quality of life outcomes ( 1 Nisi K.W. Foote R.L. Bonner J.A. et al. Adjuvant radiotherapy for squamous cell carcinoma of the tongue base: improved local-regional disease control compared with surgery alone. Int J Radiat Oncol Biol Phys. 1998; 41: 371-377 Abstract Full Text Full Text PDF PubMed Scopus (69) Google Scholar , 2 Kraus D.H. Vastola A.P. Huvos A.G. et al. Surgical management of squamous cell carcinoma of the base of the tongue. Am J Surg. 1993; 166: 384-388 Abstract Full Text PDF PubMed Scopus (75) Google Scholar , 3 Machtay M. Perch S. Markiewicz D. et al. Combined surgery and postoperative radiotherapy for carcinoma of the base of tongue: Analysis of treatment outcome and prognostic value of margin status. Head Neck. 1997; 19: 494-499 Crossref PubMed Google Scholar , 4 Thawley S.E. Simpson J.R. Marks J.E. et al. Preoperative irradiation and surgery for carcinoma of the base of the tongue. Ann Otol Rhinol Laryngol. 1983; 92: 485-490 PubMed Google Scholar , 5 Housset M. Baillet F. Dessard-Diana B. et al. A retrospective study of three treatment techniques for T1-T2 base of tongue lesions: Surgery plus postoperative radiation, external radiation plus interstitial implantation, and external radiation alone. Int J Radiat Oncol Biol Phys. 1987; 13: 511-516 Abstract Full Text PDF PubMed Scopus (90) Google Scholar , 6 Mendenhall W.M. Stringer S.P. Amdur R.J. et al. Is radiation therapy a preferred alternative to surgery for squamous cell carcinoma of the base of tongue?. J Clin Oncol. 2000; 18: 35-42 PubMed Google Scholar , 7 Blumberg A.L. Fu K.K. Phillips T.L. Results of treatment of carcinoma of the base of the tongue, the UCSF experience, 1957-1976. Int J Radiat Oncol Biol Phys. 1979; 5: 1971-1976 Abstract Full Text PDF PubMed Scopus (40) Google Scholar , 8 Jaulerry C. Rodriguez J. Brunin F. et al. Results of radiation therapy in carcinoma of the base of the tongue. The Curie Institute experience with about 166 cases. Cancer. 1991; 67: 1532-1538 Crossref PubMed Scopus (54) Google Scholar , 9 Mak A.C. Morrison W.H. Garden A.S. et al. Base-of-tongue carcinoma: Treatment results using concomitant boost radiotherapy. Int J Radiat Oncol Biol Phys. 1995; 33: 289-296 Abstract Full Text PDF PubMed Scopus (68) Google Scholar , 10 Wang C.C. Local control of oropharyngeal carcinoma after two accelerated hyperfractionation radiation therapy schemes. Int J Radiat Oncol Biol Phys. 1988; 14: 1143-1146 Abstract Full Text PDF PubMed Scopus (137) Google Scholar , 11 Brunin F. Mosseri V. Jaulerry C. et al. Cancer of the base of the tongue: Past and future. Head Neck. 1999; 21: 751-759 Crossref PubMed Scopus (72) Google Scholar , 12 Harrison L.B. Zelefsky M.J. Armstrong J.G. et al. Performance status after treatment for squamous cell cancer of the base of tongue—A comparison of primary radiation therapy versus primary surgery. Int J Radiat Oncol Biol Phys. 1994; 30: 953-957 Abstract Full Text PDF PubMed Scopus (146) Google Scholar , 13 Harrison L.B. Zelefsky M.J. Pfister D.G. et al. Detailed quality of life assessment in patients treated with primary radiotherapy for squamous cell cancer of the base of the tongue. Head Neck. 1997; 19: 169-175 Crossref PubMed Google Scholar , 14 Horwitz E.M. Frazier A.J. Martinez A.A. et al. Excellent functional outcome in patients with squamous cell carcinoma of the base of tongue treated with external irradiation and interstitial iodine 125 boost. Cancer. 1996; 78: 948-957 Crossref PubMed Scopus (53) Google Scholar ). With regard to radiation therapy, results with conventionally fractionated external beam radiation therapy (CF) alone ( 5 Housset M. Baillet F. Dessard-Diana B. et al. A retrospective study of three treatment techniques for T1-T2 base of tongue lesions: Surgery plus postoperative radiation, external radiation plus interstitial implantation, and external radiation alone. Int J Radiat Oncol Biol Phys. 1987; 13: 511-516 Abstract Full Text PDF PubMed Scopus (90) Google Scholar , 7 Blumberg A.L. Fu K.K. Phillips T.L. Results of treatment of carcinoma of the base of the tongue, the UCSF experience, 1957-1976. Int J Radiat Oncol Biol Phys. 1979; 5: 1971-1976 Abstract Full Text PDF PubMed Scopus (40) Google Scholar , 8 Jaulerry C. Rodriguez J. Brunin F. et al. Results of radiation therapy in carcinoma of the base of the tongue. The Curie Institute experience with about 166 cases. Cancer. 1991; 67: 1532-1538 Crossref PubMed Scopus (54) Google Scholar , 11 Brunin F. Mosseri V. Jaulerry C. et al. Cancer of the base of the tongue: Past and future. Head Neck. 1999; 21: 751-759 Crossref PubMed Scopus (72) Google Scholar ) are suboptimal compared to surgical therapy ( 1 Nisi K.W. Foote R.L. Bonner J.A. et al. Adjuvant radiotherapy for squamous cell carcinoma of the tongue base: improved local-regional disease control compared with surgery alone. Int J Radiat Oncol Biol Phys. 1998; 41: 371-377 Abstract Full Text Full Text PDF PubMed Scopus (69) Google Scholar , 2 Kraus D.H. Vastola A.P. Huvos A.G. et al. Surgical management of squamous cell carcinoma of the base of the tongue. Am J Surg. 1993; 166: 384-388 Abstract Full Text PDF PubMed Scopus (75) Google Scholar , 3 Machtay M. Perch S. Markiewicz D. et al. Combined surgery and postoperative radiotherapy for carcinoma of the base of tongue: Analysis of treatment outcome and prognostic value of margin status. Head Neck. 1997; 19: 494-499 Crossref PubMed Google Scholar , 4 Thawley S.E. Simpson J.R. Marks J.E. et al. Preoperative irradiation and surgery for carcinoma of the base of the tongue. Ann Otol Rhinol Laryngol. 1983; 92: 485-490 PubMed Google Scholar , 5 Housset M. Baillet F. Dessard-Diana B. et al. A retrospective study of three treatment techniques for T1-T2 base of tongue lesions: Surgery plus postoperative radiation, external radiation plus interstitial implantation, and external radiation alone. Int J Radiat Oncol Biol Phys. 1987; 13: 511-516 Abstract Full Text PDF PubMed Scopus (90) Google Scholar ) for most tongue base tumors except for select T1 lesions. As such, more intensive treatment regimens are often recommended including altered fractionation (AF) ( 6 Mendenhall W.M. Stringer S.P. Amdur R.J. et al. Is radiation therapy a preferred alternative to surgery for squamous cell carcinoma of the base of tongue?. J Clin Oncol. 2000; 18: 35-42 PubMed Google Scholar , 9 Mak A.C. Morrison W.H. Garden A.S. et al. Base-of-tongue carcinoma: Treatment results using concomitant boost radiotherapy. Int J Radiat Oncol Biol Phys. 1995; 33: 289-296 Abstract Full Text PDF PubMed Scopus (68) Google Scholar , 10 Wang C.C. Local control of oropharyngeal carcinoma after two accelerated hyperfractionation radiation therapy schemes. Int J Radiat Oncol Biol Phys. 1988; 14: 1143-1146 Abstract Full Text PDF PubMed Scopus (137) Google Scholar , 15 Fu K.K. Pajak T.F. Trotti A. et al. A Radiation Therapy Oncology Group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: First report of RTOG 9003. Int J Radiat Oncol Biol Phys. 2000; 48: 7-16 Abstract Full Text Full Text PDF PubMed Scopus (1129) Google Scholar ), the incorporation of concurrent chemotherapy (CTRT) ( 16 Calais G. Alfonsi M. Bardet E. et al. Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma. J Natl Cancer Inst. 1999; 91: 2081-2086 Crossref PubMed Scopus (974) Google Scholar , 17 Denis F. Garaud P. Bardet E. et al. Final results of the 94-01 French Head and Neck Oncology and Radiotherapy Group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma. J Clin Oncol. 2004; 22: 69-76 Crossref PubMed Scopus (716) Google Scholar ) or the addition of a brachytherapy implant (BT) to a reduced dose of CF ( 5 Housset M. Baillet F. Dessard-Diana B. et al. A retrospective study of three treatment techniques for T1-T2 base of tongue lesions: Surgery plus postoperative radiation, external radiation plus interstitial implantation, and external radiation alone. Int J Radiat Oncol Biol Phys. 1987; 13: 511-516 Abstract Full Text PDF PubMed Scopus (90) Google Scholar , 14 Horwitz E.M. Frazier A.J. Martinez A.A. et al. Excellent functional outcome in patients with squamous cell carcinoma of the base of tongue treated with external irradiation and interstitial iodine 125 boost. Cancer. 1996; 78: 948-957 Crossref PubMed Scopus (53) Google Scholar , 18 Harrison L.B. Lee H.J. Pfister D.G. et al. Long-term results of primary radiotherapy with/without neck dissection for squamous cell cancer of the base of tongue. Head Neck. 1998; 20: 668-673 Crossref PubMed Scopus (89) Google Scholar , 19 Goffinet D.R. Fee Jr., W.E. Wells J. et al. 192Ir pharyngoepiglottic fold interstitial implants. The key to successful treatment of base tongue carcinoma by radiation therapy. Cancer. 1985; 55: 941-948 Crossref PubMed Scopus (84) Google Scholar , 20 Puthawala A.A. Syed A.M. Eads D.L. et al. Limited external beam and interstitial 192iridium irradiation in the treatment of carcinoma of the base of the tongue: A ten-year experience. Int J Radiat Oncol Biol Phys. 1988; 14: 839-848 Abstract Full Text PDF PubMed Scopus (109) Google Scholar , 21 Gibbs I. Le Q. Shah R. et al. Long-term outcomes after external beam irradiation and brachytherapy boost for base-of-tongue cancers. Int J Radiat Oncol Biol Phys. 2003; 57: 489-494 Abstract Full Text Full Text PDF PubMed Scopus (43) Google Scholar , 22 Crook J. Mazeron J. Marinello G. et al. Combined external irradiation and interstitial implantation for T1 and T2 epidermoid carcinomas of base of tongue: The Creteil experience (1971–1981). Int J Radiat Oncol Biol Phys. 1998; 15: 105-114 Abstract Full Text PDF Scopus (69) Google Scholar ). AF only modestly improves locoregional control. In the RTOG 90-03 study in which 60% of patients had oropharynx cancers, hyperfractionated radiation or accelerated radiation by delayed concomitant boost resulted in a 7% improved locoregional control compared to CF and only about half (54%) were locoregionally controlled ( [15] Fu K.K. Pajak T.F. Trotti A. et al. A Radiation Therapy Oncology Group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: First report of RTOG 9003. Int J Radiat Oncol Biol Phys. 2000; 48: 7-16 Abstract Full Text Full Text PDF PubMed Scopus (1129) Google Scholar ). The addition of concurrent chemotherapy to CF improves locoregional control by 20% for oropharynx cancers and represents the standard of care for patients treated with primary external beam radiation alone ( 16 Calais G. Alfonsi M. Bardet E. et al. Randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced-stage oropharynx carcinoma. J Natl Cancer Inst. 1999; 91: 2081-2086 Crossref PubMed Scopus (974) Google Scholar , 17 Denis F. Garaud P. Bardet E. et al. Final results of the 94-01 French Head and Neck Oncology and Radiotherapy Group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced-stage oropharynx carcinoma. J Clin Oncol. 2004; 22: 69-76 Crossref PubMed Scopus (716) Google Scholar ). BT combined with a reduced dose of CF has a long history of successful treatment of tongue base tumors and its role in current management will be reviewed in light of advances in treatment delivery with intensity modulated radiation (IMRT) and the use of concurrent chemoradiation." @default.
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