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

Erkal, Haldun Ş; Serin, Meltem; Amdur, Robert J; Villaret, Douglas B; Stringer, Scott P; Mendenhall, William M

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Volume 50, Issue 2 , Pages 359-366, 1 June 2001

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

Haldun Ş Erkal, M.D.
- Department of Radiation Oncology, Inönü University Faculty of Medicine, Malatya, Turkey
Meltem Serin, M.D.
- Department of Radiation Oncology, Inönü University Faculty of Medicine, Malatya, Turkey
Robert J Amdur, M.D.
- Department ofRadiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA
Douglas B Villaret, M.D.
- Department ofOtolaryngology, University of Florida College of Medicine, Gainesville, FL, USA
Scott P Stringer, M.D.
- Department ofOtolaryngology, University of Florida College of Medicine, Gainesville, FL, USA
William M Mendenhall, M.D.
- Department ofRadiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA
- Correspondence to: William M. Mendenhall, M.D., Department of Radiation Oncology, University of Florida Health Science Center, P.O. Box 100385, Gainesville FL 32610-0385. Tel: (352) 265-0287; Fax: (352) 265-0759 Reprints not available

Accepted 4 December 2000.

Abstract

Purpose: The present study presents the experience at the University of Florida with treatment of unselected patients with carcinomas of the soft palate with radiation therapy (RT) alone or followed by planned neck dissection.

Methods and Materials: One hundred seven patients treated with curative intent with RT alone or followed by neck dissection from 1965 to 1996 were included in the study. All patients had follow-up for at least 2 years. No patients were lost to follow-up.

Results: Local control rates at 5 years were 86% for T1, 91% for T2, 67% for T3, and 36% for T4 carcinomas. T-stage and overall treatment time significantly affected local control in multivariate analysis. Nodal control rates at 5 years were 86% for N0, 76% for N1, 61% for N2, and 67% for N3 carcinomas. Overall treatment time and planned neck dissection significantly affected 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 dissection significantly affected ultimate local-regional control in multivariate analysis. The overall survival rate at 5 years was 42% for all patients. Overall stage, overall treatment time, and planned neck dissection significantly affected overall survival in multivariate analysis. The cause-specific survival rate at 5 years was 70% for all patients. Overall treatment time and planned neck dissection significantly affected cause-specific survival in multivariate analysis. Three patients sustained severe postoperative complications and 3 patients sustained severe late complications. Sixteen patients 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 followed by planned neck dissection) results in relatively high local-regional control and survival rates. For advanced carcinomas of the soft palate, local-regional control and survival rates are relatively low and local-regional recurrence rates are substantial. Advanced carcinomas of the soft palate may be better treated with RT and concomitant chemotherapy.

Keywords: Soft palate, Squamous cell carcinoma, Radiotherapy, Planned neck dissection