Primary radiation therapy in the treatment of squamous cell carcinoma of the soft palate

Abstract

From 1970 to 1986, 45 patients received primary radiation therapy for squamous cell carcinoma of the soft palate at the University of California Los Angeles (UCLA) Center for the Health Sciences and Wadsworth Veteran's Administration Hospital. Seven patients were lost to follow-up or had prior irradiation, and were excluded. Thirty-eight patients received a median dose of 70 Gy (62.5 to 80 Gy) to the primary site. After a median follow-up of 48 months, initial control of disease at the primary site was accomplished in 74% of the patients. The initial control by stage was as follows: TI, 83%, T2, 67%; and T3, 63%. After surgical salvage, local control increased to 92%, 80% and 75% for stages T1, T2, and T3, respectively. Twenty-nine percent (11 of 38) of the patients had cervical node metastases at presentation. Radiation provided regional control in 96% (26 of 27) with N0 disease and 86% (six of seven) with N1 disease at diagnosis. Sixteen patients (42%) had an additional malignancy of the upper aerodigestive tract. Because the incidence of second malignancies after treatment is high and surgical salvage of treatment failures is possible, close follow-up is essential in the management of this tumor. We conclude that radiation therapy is an effective modality for the treatment of squamous cell carcinoma of the soft palate. Primary radiation therapy may offer many patients the chance to avoid surgical procedures that are both cosmetically and functionally debilitating without compromosing treatment outcome.

Surgical management of squamous cell carcinoma of the soft palate: Factors predictive of outcome

“…Many clinicians argue that SCCSP should be grouped together with SCC arising from other oropharyngeal sites (tonsil and base of tongue) and treated primarily with radiation therapy (with or without chemotherapy), in the manner of an “organ‐preservation protocol,” although strictly there is no “organ” to preserve. In this regard, a large number of studies published in recent times have focused on primary radiation therapy as the modality of treatment for these cancers reporting consistently good outcomes 3, 13–16. However, some maintain that these cancers should be grouped together with oral cavity malignancies, and primary surgery should be performed for easily accessible, early‐stage disease 17–20.…”

Radiation treatment of soft palate squamous cell carcinoma

“…Other institutions have reported their experiences treating soft palate squamous cell carcinomas (Table 5). [7][8][9][10][11][12][13][14][15][16][17][18] Most prior studies report local control based on tumor stage but few provide stagestratified local-regional control rates or survival rates.…”

Tratamento do carcinoma epidermóide do palato mole

“…Squamous cell carcinoma is a predominant histological type, which presents high incidence of second primary tumor associated with tumors of this site, either synchronous or metachronous 1 . The soft palate plays an important role in both swallowing and phonation, what makes rehabilitation difficult and determines radiotherapy as tumor treatment of choice, according to several publications [2][3][4][5][6] . Notwithstanding, soft palate tumors usually present early lymph node involvement -frequently bilateral -where radiotherapy is not sufficient to control the disease 7 .…”