PURPOSE: The optimal management of oral cavity squamous cell carcinoma (OCSCC) typically involves surgical resection followed by adjuvant radiotherapy or chemoradiotherapy (CRT) in the setting of adverse pathologic features. Intensity-modulated radiation therapy (IMRT) is frequently used to treat oral cavity cancers, but published IMRT outcomes specific to this disease site are sparse. We report the Dana-Farber Cancer Institute experience with IMRT-based treatment for OCSCC. METHODS AND MATERIALS: Retrospective study of all patients treated at Dana-Farber Cancer Institute for OCSCC with adjuvant or definitive IMRT between August 2004 and December 2009. The American Joint Committee on Cancer disease stage criteria distribution of this cohort included 5 patients (12%) with stage I; 10 patients (24%) with stage II (n = 10, 24%); 14 patients (33%) with stage III (n = 14, 33%); and 13 patients (31%) with stage IV. The primary endpoint was overall survival (OS); secondary endpoints were locoregional control (LRC) and acute and chronic toxicity. RESULTS: Forty-two patients with OCSCC were included, 30 of whom were initially treated with surgical resection. Twenty-three (77%) of 30 surgical patients treated with adjuvant IMRT also received concurrent chemotherapy, and 9 of 12 (75%) patients treated definitively without surgery were treated with CRT or induction chemotherapy and CRT. With a median follow-up of 2.1 years (interquartile range, 1.1-3.1 years) for all patients, the 2-year actuarial rates of OS and LRC following adjuvant IMRT were 85% and 91%, respectively, and the comparable results for definitive IMRT were 63% and 64% for OS and LRC, respectively. Only 1 patient developed symptomatic osteoradionecrosis, and among patients without evidence of disease, 35% experienced grade 2 to 3 late dysphagia, with only 1 patient who was continuously gastrostomy-dependent. CONCLUSIONS: In this single-institution series, postoperative IMRT was associated with promising LRC, OS, and lower late toxicity rates, and chemoradiotherapy was a successful treatment for patients with high-risk disease. In contrast, outcomes of radiation-based treatment for patients with inoperable locally advanced disease were markedly less successful.
PURPOSE: The optimal management of oral cavity squamous cell carcinoma (OCSCC) typically involves surgical resection followed by adjuvant radiotherapy or chemoradiotherapy (CRT) in the setting of adverse pathologic features. Intensity-modulated radiation therapy (IMRT) is frequently used to treat oral cavity cancers, but published IMRT outcomes specific to this disease site are sparse. We report the Dana-Farber Cancer Institute experience with IMRT-based treatment for OCSCC. METHODS AND MATERIALS: Retrospective study of all patients treated at Dana-Farber Cancer Institute for OCSCC with adjuvant or definitive IMRT between August 2004 and December 2009. The American Joint Committee on Cancer disease stage criteria distribution of this cohort included 5 patients (12%) with stage I; 10 patients (24%) with stage II (n = 10, 24%); 14 patients (33%) with stage III (n = 14, 33%); and 13 patients (31%) with stage IV. The primary endpoint was overall survival (OS); secondary endpoints were locoregional control (LRC) and acute and chronic toxicity. RESULTS: Forty-two patients with OCSCC were included, 30 of whom were initially treated with surgical resection. Twenty-three (77%) of 30 surgical patients treated with adjuvant IMRT also received concurrent chemotherapy, and 9 of 12 (75%) patients treated definitively without surgery were treated with CRT or induction chemotherapy and CRT. With a median follow-up of 2.1 years (interquartile range, 1.1-3.1 years) for all patients, the 2-year actuarial rates of OS and LRC following adjuvant IMRT were 85% and 91%, respectively, and the comparable results for definitive IMRT were 63% and 64% for OS and LRC, respectively. Only 1 patient developed symptomatic osteoradionecrosis, and among patients without evidence of disease, 35% experienced grade 2 to 3 late dysphagia, with only 1 patient who was continuously gastrostomy-dependent. CONCLUSIONS: In this single-institution series, postoperative IMRT was associated with promising LRC, OS, and lower late toxicity rates, and chemoradiotherapy was a successful treatment for patients with high-risk disease. In contrast, outcomes of radiation-based treatment for patients with inoperable locally advanced disease were markedly less successful.
Authors: Benjamin H Lok; Christine Chin; Nadeem Riaz; Felix Ho; Man Hu; Julian C Hong; Weiji Shi; Zhigang Zhang; Eric Sherman; Richard J Wong; Luc G Morris; Ian Ganly; Suzanne L Wolden; Shyam S Rao; Nancy Y Lee Journal: Head Neck Date: 2014-08-28 Impact factor: 3.147
Authors: Michael T Spiotto; Gina Jefferson; Barry Wenig; Michael Markiewicz; Ralph R Weichselbaum; Matthew Koshy Journal: JAMA Otolaryngol Head Neck Surg Date: 2017-07-01 Impact factor: 6.223
Authors: Evangelia Katsoulakis; Jonathan E Leeman; Benjamin H Lok; Weiji Shi; Zhigang Zhang; Jillian C Tsai; Sean M McBride; Eric J Sherman; Marc Cohen; Richard Wong; Ian Ganly; Nancy Y Lee; Nadeem Riaz Journal: Laryngoscope Date: 2018-04-10 Impact factor: 3.325
Authors: Steven B Chinn; Matthew E Spector; Emily L Bellile; Laura S Rozek; Tasha Lin; Theodoros N Teknos; Mark E Prince; Carol R Bradford; Susan G Urba; Thomas E Carey; Avraham Eisbruch; Gregory T Wolf; Francis P Worden; Douglas B Chepeha Journal: JAMA Otolaryngol Head Neck Surg Date: 2014-02 Impact factor: 6.223
Authors: Gabriela Studer; Michelle Brown; Marius Bredell; Klaus W Graetz; Gerhard Huber; Claudia Linsenmeier; Yousef Najafi; Oliver Riesterer; Tamara Rordorf; Stephan Schmid; Christoph Glanzmann Journal: Radiat Oncol Date: 2012-06-11 Impact factor: 3.481