Asbestos Cancer Update 2008

Department of Head and Neck, Cancer Institute Hospital, Japanese Foundation for Cancer Research, 3-10-6 Ariake Koutou-ku, Tokyo, Japan. seyosimoto@jfcr.or.jp

CONCLUSIONS: For T2 tumors, surgery was indicated if functional preservation was possible. For T3/T4 tumors, the rate of primary disease control was not high and surgery frequently involved total laryngectomy. Points that surgeons must heed when performing such surgery were delineated. OBJECTIVES: Because tumors originating from the base of the tongue are rare, few large-scale studies of such tumors have been performed. We reviewed treatments and outcomes at our department to establish effective future therapeutic plans. PATIENTS AND METHODS: From 1971 to 2000, 84 patients with previously untreated and resectable squamous cell carcinoma of the base of the tongue were treated at the Head and Neck Department of the Cancer Institute Hospital, Tokyo. Treatment selection and results were investigated. RESULTS: The main treatment options were radiotherapy for primary lesions < or = T2 and surgery for primary lesions > or = T3. Overall disease-specific 5-year cumulative survival rate was 59.8%, but there was no significant difference in survival rate at each stage between the two treatments. Among patients who died of the primary disease, the area that was most difficult to control was the superior margin of the lateral wall of the oropharynx (n=7). The incidence of contralateral or retropharyngeal lymph node metastasis was low if tumors neither crossed the midline nor infiltrated the lateral wall. While total laryngectomy was performed on 48 patients, the larynx was operatively preserved in 5 T3 patients and one T4 patient.

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Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Japan.

OBJECTIVE: The objective of this study was to improve the treatment results for locally advanced tongue cancer. A combination of radiotherapy with continuous intra-arterial therapy using CBDCA was used. STUDY DESIGN: According to TNM staging (1997), 29 patients had stage III lesions and 11 patients had stage IV (M0) lesions. A catheter was inserted through the lingual artery in 26 patients, through the external carotid artery in 11 patients, and through the faciolingual trunk in 2 patients. CBDCA was continuously infused for 4 to 6 weeks. With IA chemotherapy, external irradiation (median dose: 46.8 Gy) was simultaneously performed, and 1 to 2 courses of systemic chemotherapy were performed in 19 patients before intra-arterial chemotherapy. RESULTS: The 5-year local control rate was 65%. The 5-year OS rate was 39.5%. There were no clinically significant adverse side effects. CONCLUSION: Continuous IA CBDCA and concurrent radiation therapy can be delivered safely with good efficacy for locally advanced carcinoma of the tongue.

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