Outcomes of oral cavity cancer patients treated with surgery followed by postoperative intensity modulated radiation therapy

Abstract

Objectives Although treatment paradigms have not changed significantly, radiotherapy, surgery, and imaging techniques have improved, leading us to investigate oncologic and survival outcomes for oral cavity squamous cell cancer (OCSCC) patients treated with surgery followed by postoperative IMRT. Material and Methods Records of patients with pathological diagnosis of OCSCC treated between 2000–2012 were retrospectively reviewed. Patients’ demographic, disease, and treatment criteria were extracted. Kaplan-Meier method was used to calculate survival curves. Results Two hundred eighty-nine patients were analyzed. Median follow-up was 35 months. Two hundred sixty-eight had neck dissections (93%), of which 66% had nodal involvement, and 51% of those positive dissections had extracapsular extension. Forty patients received induction chemotherapy and 107 received concurrent chemotherapy. Median dose to high risk clinical target volume was 60 Gy/30 fractions. The 5-year locoregional control and overall survival rates were 76% and 57%, respectively. Tumors with >1.5 cm depth of invasion had significantly higher risk of local failure compared with ≤1.5 cm (p<0.001). In multivariate analysis, positive and no neck dissection (p=0.01), positive lymphovascular invasion (p=0.006) and >1.5 cm depth of invasion (p=0.003) were independent predictors of poorer survival. Conclusions Disease outcomes were consistent with historical data and did not appear compromised by the use of IMRT.

Prognostic significance of smoking and alcohol history in young age oral cavity cancer

“…reported a significantly lower recurrence-free survival and a higher incidence of local recurrence in heavier smokers (Fang, Shi, Liu, & Sun, 2014), but another study reported significantly improved local control rates in patients who smoked more than 20 PY compared to non-smokers (Quinlan-Davidson et al, 2017). Besides, in a prognostic factor analysis of 85 patients with stage I-II oral tongue cancer treated primarily by surgery, 5-year relapse-free survival showed no significant difference by smoking status (75% with smoking versus.…”

Analysis of primary oral and oropharyngeal squamous cell carcinoma in inhabitants of Beijing, China—a 10-year continuous single-center study

“…A study carried out in the Netherlands, from 1989 to 2011, demonstrated that patients diagnosed with oral and oropharyngeal SCC responded better to treatments, increasing the survival rate to 67 and 48%, respectively, in cases of oral cavity and oropharyngeal cancers [23]. Quinlan-Davidson et al studied 289 patients with OSCC who were treated with surgery followed by postoperative intensity modulated radiotherapy and observed a 5-year overall survival of 57% [24]. Some authors reported that survival rates were better in more developed countries than in developing ones [25].…”

Analysis of primary oral and oropharyngeal squamous cell carcinoma in inhabitants of Beijing, China—A 10-year continuous single-center study

“…Quinlan-Davidson et al studied 289 patients with OSCC who were treated with surgery followed by postoperative intensity modulated radiotherapy and observed a 5-year overall survival of 57% 24 .…”