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Japanese Journal of Clinical Oncology Advance Access originally published online on November 9, 2006
Japanese Journal of Clinical Oncology 2007 37(1):62-65; doi:10.1093/jjco/hyl120
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© 2006 Foundation for Promotion of Cancer Research

Carcinoma of the Floor of the Mouth: A Case Treated with Precisely Controlled External Beam Radiotherapy

Seiko Nishioka1 and Takeshi Nishioka2,

1 Department of Radiology, NTT East-Japan Sapporo Hospital
2 Department of Health Sciences Laboratory of Radiation Therapy, Hokkaido University School of Medicine, Sapporo, Japan

For reprints and all correspondence: Takeshi Nishioka, Department of Health Sciences Laboratory of Radiation Therapy, Hokkaido University School of Medicine, Kita 14, Nishi 5, Kita-ku, Sapporo, Hokkaido, Japan. E-mail: trout{at}radi.med.hokudai.ac.jp

Received May 16, 2006; accepted July 27, 2006

A new external radiotherapy system has been developed for head and neck cancer and a case with T2 oral floor carcinoma treated with this system is presented in this report. The system consists of real-time tumor-tracking equipment and a gold-marker implanted mouthpiece. Accuracy of the order of 2 mm was achieved during the entire course of fractionated radiotherapy (a total of 52.5 Gy in 15 fractions). Planning target volume became smaller compared to the conventional parallel-opposed technique. Dose–volume histogram analysis demonstrated a significant reduction in the dose to the mandible bone compared to the conventional technique. A confluent fibrinous mucositis developed in the oral floor mucosa that corresponded to 90% dose area. Mucositis in the lower gum was minimal and analgesics were not required. The patient is currently free from both tumor and complication during a follow-up period of 48 months. External radiotherapy can be an option as a curative treatment for early stage carcinoma of the floor of the mouth provided that patient set-up is rigid and reproducible.

Key Words: Oral floor cancer • external radiotherapy • RTRT


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