[Preoperative Radiochemotherapy for Advanced Oral Cavity Tumours : the Kiel DOSAK Experience Regarding Curability and Quality of Life].

BACKGROUND:According the guidelines of the German-Austrian-Swiss Council for maxillary and facial tumours (DOSAK), patients with advanced oral cavity tumours underwent preoperative radiochemotherapy followed by radical surgery. The results were to be evaluated with regard to curability and quality of life and compared with the current literature.PATIENTS AND METHODS:Between 1993 and 1998, 52 patients were treated. Radiotherapy up to a total dose of 36 Gy was combined with one cycle of cisplatin (12.5 mg/m2, days 1-5) chemotherapy. Besides clinical data concerning radiogenic toxicity and surgical complications, quality of life after therapy was of special interest.RESULTS:Three years after therapy 33 of 52 patients (63.5%) were alive, and after 5 years 19 of 33 patients (57.6%) were still alive. Seven patients (14.6%) had a local recurrence. Side effects of radiotherapy according RTOG scoring were minor; only one patient (1.9%) had grade 3 toxicity. Of 48 patients, 9 (18.7%) had no surgical complications. Quality of life was good in only 14 patients (29.2%); all the other patients (70.8%) suffered from impaired quality of life.CONCLUSIONS:Preoperative radiochemotherapy in advanced oralcavity carcinomas with subsequent radical surgery is an effective treatment regarding long-term survival. The treatment is burdened by lasting impaired quality of life. High scientific priority should hence be directed to a steady improvement of quality of life in these patients.