RESEARCH FOR IMPROVEMENT OF CURATIVE RATE AND LATE EFFECT IN THE TREATMENT OF ORAL CANCER WITH THE USE OF HYPERFRACTIONATED RADIOTHERAPY.

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To estimate the efficacy of hyperfractionated radiotherapy for oral cancer, a clinical trial was conducted. Twenty one patients with previously untreated and biopsy-proven squamous cell carcinoma ofhe oral cavity were entered in this study. Two-year survival rate was high, 66.7% because there were more patients with T1 or T2 tumor than those with T3 or T4 tumor and also because salvage surgery worked well. However, there was not any variable which made a survival rate to improve using hyperfractionated radiotherapy. Local control rate was influenced by the size of tumor. A higher control rate was obtained in the patients with lower stages of tumor, and it was considered from the stad point of organ preservation that a small size of gaingival or buccal carcinoma would be involved in indications for hyperfractionated radiotherapy. On the contrary, a control rate of advanced diseases was the same as that of published data. Modifications of a total dose and a combination of chemotherapy wo … More uld be a subject which should be disclosed as quickly as possible. The grade of acute mucosal reaction was severer than that in the conventional fractionation. It was, however, estimated as tolerable and any split in the treatment was not needed. The incidence of late reactions was low, possibly due to a shorter period of follow-up, but it was suggested that the close management of the whole oral cavity was necessary in the patients.From these findings in the trial, we tried to compare preliminary results between the treatment with hyperfractionated radiotherapy alone and the combined treatment of hyperfracionated radiotherapy and chemotherapy for the development of a clinical management in the future. Local control rates were improved unsuccessfully when hyperfractionated radiotherapy alone was used, but those were improved when chemotherapy was used with a combination of hyperfractionated radiotherapy. Although a clinical advantage of the combination of chemotherapy and a better mode of the combination have not shown yet, we consider that the combination of chemotherapy would be an actual choice to obtain an improvement of therapeutic ratio. Less