Abstract
We report a case of cancer of the oral floor (T4aN3M0) treated successfully with thermochemoradiotherapy.
A male in his 60's with a mass in the oral floor was referred to our department. There was a tumor in the oral floor measuring 40 × 35 mm and left cervical swelling. CT images showed that the tumor had invaded extrinsic tongue muscles and its size was 42 × 35 × 30 mm, and there were also large metastatic lymph nodes from level II to IV. After the biopsy, the patient was diagnosed as squamous cell carcinoma of the oral floor (T4aN3M0). As the patient wanted to preserve oral function and refused to undergo operation of the primary site excluding neck dissection, we performed superselective intra-arterial chemotherapy via bilateral superficial temporal arteries (cisplatin: total 264 mg, docetaxel: total 144 mg) with daily concurrent radiotherapy (1.8 Gy/day, total 59.4 Gy) and thermoradiotherapy for cervical lymph node metastases (RF capacitive hyperthermia: twice). After the treatments, the primary and cervical sites became remarkably small. Although the treatment effect was complete response of the primary tumor and cervical lymph node metastases 6 weeks after the treatment, CT images revealed lung metastasis. The patient died 20 months after the initial treatments in spite of chemotherapy. During follow-up, there was no recurrence of the primary tumor or cervical lymph node metastases.
