CO2 laser in treating carcinoma of the tongue

Since 1980, we have been using CO2 laser in treating carcinomas of the tongue. Carcinomas confined to the mucosa have been treated with laser excision alone. Five patients were treated in this way and they are all alive with no evidence of disease. Follow-up ranges from 11 months to 3 years. Carcinomas with a superficial muscular invasion have been treated with mass reduction laser surgery followed by chemoradiotherapy. There were 19 patients which fell in this category. Of these 19, 17 are alive with no evidence of disease, 1 died of an intercurrent disease, and 1 died of cervical metastasis. Follow-up ranges from 9 months to 5 years and 1 month. For carcinomas with a deep muscular invasion, we first attempted an induction chemotherapy consisting of cisplatin and pepleomycin. When the chemotherapy was effective, we applied mass reduction laser surgery followed by chemoradiotherapy. Two patients were treated in this way. One is alive with no evidence of disease (11-month follow-up) whereas the other died of pulmonary metastasis. Following the treatments using laser, speech intelligibility is much better than after extensive surgeries.