The Varese Regional Hospital experience with radiotherapy for Retromolar Trigone Carcinomas

Retromolar Trigone Carcinomas (RTC) are generally diagnosed at an advanced stage in spite of their accessible location. From December 1979 to January 1987 we examined 23 patients with RTC at the Varese Regional Hospital -three women and twenty men, with an average age of 62.9 years. 21/23 patients were heavy cigarette smokers and consumed more than 1 l of alcohol per day. The patients were classified as 1 T1, 9 T2, 9 T3 and 4 T4 on the basis of TNM classification of malignant tumors. At the beginning of the treatement 12 patients had latero-cervical metastatic nodes. Fifteen patients underwent radiotherapy with Cobalt 60 with doses ranging from 60 to 70 Gy. The patients without evident metastatic cervical nodes were also irradiated with doses of at least 45 Gy as a precautionary measure. The percentage of cumulative survival of these patients amounts to 41.1% after 3 years, while for relapse-free patients pcs amounts to 40.7% after 3 years. In view of our results, we do not consider radiotherapy alone an effective treatement as a local cure for RTC. We intend to set up a new therapeutic protocol which incorporate surgery with radiotherapy and includes chemotherapy as necessary on the basis of T volume and of the presence of loco-regional metastatic nodes