Tae Hyung Kim1,2, In-Ho Cha3, Eun Chang Choi4, Hye Ryun Kim5, Hyung Jun Kim3, Se-Heon Kim4, Ki Chang Keum1, Chang Geol Lee1. 1. Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea. 2. Department of Radiation Oncology, Eulji General Hospital, College of Medicine, Eulji University, Seoul, South Korea. 3. Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, South Korea. 4. Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea. 5. Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, South Korea.
Abstract
BACKGROUND/ PURPOSE: Surgery followed by postoperative radiotherapy (RT) has been considered the standard treatment for oral cavity squamous cell carcinoma (OCSCC) of advanced stages or with adverse prognostic factors. In this study, we compared the outcomes in patients with OCSCC who received postoperative concurrent chemoradiotherapy (CCRT) or postoperative RT alone using modern RT techniques. METHODS: A total of 275 patients with OCSCC treated between 2002 and 2018 were retrospectively analyzed. Adverse prognostic factor was defined as extranodal extension (ENE), microscopically involved surgical margin, involvement of ≥2 lymph nodes, perineural disease, and/or lymphovascular invasion (LVI). In total, 148 patients (54%) received CCRT and 127 patients (46%) received RT alone. More patients in the CCRT group had N3 disease and stage IVB disease (46.6% vs. 10.2%, p<0.001), ENE (56.1% vs. 15.7%, p<0.001), LVI (28.4% vs. 13.4%, p=0.033). RESULTS: With a median follow-up of 40 (range, 5-203) months, there were no significant differences in the 5-year overall survival (OS) and PFS between treatment groups. In the subgroup analysis according to high risk, the concurrent use of chemotherapy showed significantly improved OS in patients with ENE (HR 0.39, p=0.003). CONCLUSION: Our retrospective study showed that postoperative CCRT group had comparable survival outcomes to those in the RT alone group for advanced OCSCC in the era of modern RT techniques and indicated that concurrent chemotherapy should be administered to patients with ENE. Prospective randomized studies for confirmation are needed.
BACKGROUND/ PURPOSE: Surgery followed by postoperative radiotherapy (RT) has been considered the standard treatment for oral cavity squamous cell carcinoma (OCSCC) of advanced stages or with adverse prognostic factors. In this study, we compared the outcomes in patients with OCSCC who received postoperative concurrent chemoradiotherapy (CCRT) or postoperative RT alone using modern RT techniques. METHODS: A total of 275 patients with OCSCC treated between 2002 and 2018 were retrospectively analyzed. Adverse prognostic factor was defined as extranodal extension (ENE), microscopically involved surgical margin, involvement of ≥2 lymph nodes, perineural disease, and/or lymphovascular invasion (LVI). In total, 148 patients (54%) received CCRT and 127 patients (46%) received RT alone. More patients in the CCRT group had N3 disease and stage IVB disease (46.6% vs. 10.2%, p<0.001), ENE (56.1% vs. 15.7%, p<0.001), LVI (28.4% vs. 13.4%, p=0.033). RESULTS: With a median follow-up of 40 (range, 5-203) months, there were no significant differences in the 5-year overall survival (OS) and PFS between treatment groups. In the subgroup analysis according to high risk, the concurrent use of chemotherapy showed significantly improved OS in patients with ENE (HR 0.39, p=0.003). CONCLUSION: Our retrospective study showed that postoperative CCRT group had comparable survival outcomes to those in the RT alone group for advanced OCSCC in the era of modern RT techniques and indicated that concurrent chemotherapy should be administered to patients with ENE. Prospective randomized studies for confirmation are needed.
Authors: Jay S Cooper; Qiang Zhang; Thomas F Pajak; Arlene A Forastiere; John Jacobs; Scott B Saxman; Julie A Kish; Harold E Kim; Anthony J Cmelak; Marvin Rotman; Robert Lustig; John F Ensley; Wade Thorstad; Christopher J Schultz; Sue S Yom; K Kian Ang Journal: Int J Radiat Oncol Biol Phys Date: 2012-06-30 Impact factor: 7.038
Authors: Satvir Saggi; Karam W Badran; Albert Y Han; Edward C Kuan; Maie A St John Journal: Otolaryngol Head Neck Surg Date: 2018-02-13 Impact factor: 3.497
Authors: Piyush Gupta; Jocelyn C Migliacci; Pablo H Montero; Daniella Karassawa Zanoni; Jatin P Shah; Snehal G Patel; Ian Ganly Journal: Oral Oncol Date: 2018-02-20 Impact factor: 5.337
Authors: Jacques Bernier; Jay S Cooper; T F Pajak; M van Glabbeke; J Bourhis; Arlene Forastiere; Esat Mahmut Ozsahin; John R Jacobs; J Jassem; Kie-Kian Ang; J L Lefèbvre Journal: Head Neck Date: 2005-10 Impact factor: 3.147
Authors: Adepitan A Owosho; C Jillian Tsai; Ryan S Lee; Haley Freymiller; Arvin Kadempour; Spyridon Varthis; Adi Z Sax; Evan B Rosen; SaeHee K Yom; Joseph Randazzo; Esther Drill; Elyn Riedel; Snehal Patel; Nancy Y Lee; Joseph M Huryn; Cherry L Estilo Journal: Oral Oncol Date: 2016-12-03 Impact factor: 5.337
Authors: Andrew K Chan; Shao Hui Huang; Lisa W Le; Eugene Yu; Laura A Dawson; John J Kim; B C John Cho; Andrew J Bayley; Jolie Ringash; David Goldstein; Kelvin Chan; John Waldron; Brian O'Sullivan; Bernard Cummings; Andrew J Hope Journal: Oral Oncol Date: 2012-10-15 Impact factor: 5.337
Authors: Alessia Di Rito; Francesco Fiorica; Roberta Carbonara; Francesca Di Pressa; Federica Bertolini; Francesco Mannavola; Frank Lohr; Angela Sardaro; Elisa D'Angelo Journal: Cancers (Basel) Date: 2022-07-29 Impact factor: 6.575