ORIGINAL ARTICLE DEFINITIVE RADIATION THERAPY FOR SQUAMOUS CELL CARCINOMA OF THE SOFT PALATE Bhishamjit S. Chera, MD, 1 Robert J. Amdur, MD, 1 Russell W. Hinerman, MD, 1 Christopher G. Morris, MD, 1 Douglas B. Villaret, MD, 2 John W. Werning, MD, 2 William M. Mendenhall, MD 1 1 Department of Radiation Oncology, University of Florida, Gainesville, Florida. E-mail: mendwm@shands.ufl.edu 2 Department of Otolaryngology, University of Florida, Gainesville, Florida Accepted 17 January 2008 Published online 9 July 2008 in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/hed.20848 Abstract: Background. We report the University of Florida experience with soft-palate carcinoma treated with radiotherapy alone or combined with adjuvant chemotherapy and/or neck dis- section for residual disease in the neck. Methods. A total of 145 patients treated with curative intent from 1963 to 2004 were included. Potential follow-up was 2 years. Results. Local control rates at 5 years were: T1, 90%; T2, 91%; T3, 67%; T4, 57%. Nodal control rates at 5 years were: N0, 90%; N1, 82%; N2, 68%; N3, 71%. Ultimate local-regional control rates at 5 years were: stage I, 89%; stage II, 88%; stage III, 96%; stage IVA, 63%; stage IVB, 43%. In multivariate analysis, overall treatment time significantly affected local and ultimate local-re- gional control, and nodal stage significantly affected overall sur- vival. Overall survival rate at 5 years was 44%. Cause-specific sur- vival rate at 5 years was 73%. Conclusions. The likelihood of cure after definitive radiother- apy is relatively high and is impacted by disease extent and overall treatment time. V V C 2008 Wiley Periodicals, Inc. Head Neck 30: 1114–1119, 2008 Keywords: soft palate; radiation therapy; squamous cell carci- noma The National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) statistical database estimates that there will be 11,800 cases of oropharyngeal cancer in the United States in 2007 (http://seer.cancer.gov/). At the University of Florida, 1 of every 4 patients with squamous cell carcinoma of the oropharynx has a primary soft- palate tumor. 1 Treatment options for squamous cell carcinomas of the soft palate include radiation therapy (RT) alone, surgery alone, or surgery fol- lowed by postoperative radiotherapy. 2–11 Chemo- therapy is often used concurrently with RT for advanced disease. 12–14 The current policy at the University of Florida has been to treat all previ- ously unirradiated patients with RT alone, with concurrent chemotherapy for advanced-stage dis- ease, and neck dissection reserved for residual radiographically suspicious nodes on a CT scan performed 1 month after completing RT. This study presents the treatment outcomes at the University of Florida for patients with squamous cell carcinomas of the soft palate. PATIENTS AND METHODS From 1963 to 2004, 145 patients with previously untreated squamous cell carcinomas of the soft palate or uvula were treated with definitive RT at Correspondence to: W. M. Mendenhall V V C 2008 Wiley Periodicals, Inc. 1114 Squamous Cell Carcinoma of the Soft Palate HEAD & NECK—DOI 10.1002/hed August 2008