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Japanese Journal of Clinical Oncology Advance Access published online on November 9, 2006
Japanese Journal of Clinical Oncology, 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

Department of Health Sciences Laboratory of Radiation Therapy, Hokkaido University School of Medicine, Kita 14, Nishi 5, Kita-ku, Sapporo, Hokkaido, Japan. 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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