Postoperative radiotherapy for oral cancer patients with high risk of recurrence
Tomomi Tsujimoto, Hiroaki Shimamoto, Naoya Kakimoto, Shumei Murakami,
Souhei Furukawa
Department of Oral and Maxillofacial Radiology, Osaka University Graduate
School of Dentistry
Introduction and objectives
Oral cancer patients who have high risk of loco-regional recurrence after surgery
are commonly treated with postoperative radiotherapy. As already documented
various papers, histopathological findings from surgical specimen were
to examine a risk for loco-regional recurrence.
The purpose of this study was to evaluate outcomes of the postoperative
radiotherapy for oral cancer patients with high risk of loco-regional recurrence.
In addition, we compared treatment results of concurrent chemotherapy and
radiotherapy with radiotherapy alone as adjuvant treatment for high risk of
loco-regional recurrence.
Methods
We retrospectively reviewed 49 patients with high risk of recurrence (at least one
histopathological finding: positive or close margin, extracapsular tumor
or pN2b-N3) who were treated with postoperative radiotherapy for oral cancer, of
which 21 patients underwent concurrent chemotherapy. Median follow up was
months. The radiation techniques were three-dimensional conformal radiation
therapy for 44 patients and intensity modulated radiation therapy for five patients.
Total dose ranged from 54 to 66 Gy (median dose was 60 Gy).
Results and Discussion
The 3-year loco-regional control (LRC), disease-free survival (DFS), overall
survival (OS) and cause-specific survival (CSS) rates were 70%, 49%, 69% and
73%, respectively. Postoperative radiotherapy is considered to be useful for oral
cancer patients with high risk of loco-regional recurrence.
The 3-year LRC rates for postoperative radiotherapy with and without concurrent
chemotherapy were 79% and 66%. The 3-year OS rates for postoperative
radiotherapy with and without concurrent chemotherapy were 82% and 62%.
Conclusions
Although DFS rate was not over 50%, LRC, OS, and CSS were relatively high
(about 70%). And, the postoperative radiotherapy with concurrent chemotherapy
did not improve the survival rates in patients with high risk of loco-regional
recurrence.