Follow up after IMRT in oral cavity cancer: update
1 Department of Radiation Oncology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland
2 Department of Cranio-Maxillofacial Surgery, University Hospital, Zurich, Switzerland
3 Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Zurich, Switzerland
4 Department of Medical Oncology, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland
5 Otorhinolaryngology, Klinik Bethanien, Toblerstrasse 51, 8044, Zurich, Switzerland
Radiation Oncology 2012, 7:84 doi:10.1186/1748-717X-7-84Published: 11 June 2012
Except for early stages (T1/2 N0), the prognosis for patients with oral cavity cancer (OCC) is known to be worse than for those with pharyngeal carcinoma. While definitive intensity modulated radiation therapy (IMRT)-chemotherapy affords loco-regional control rates (LRC) of approximately 80% in advanced pharyngeal cancer, corresponding rates are reported to be much lower for OCC. The aim of this work was to evaluate loco-regional disease control and overall survival (OAS) in a relatively large OCC patient cohort treated in the IMRT era.
Methods and materials
Between October 2002 and June 2011, 160 OCC patients were treated with curative intention IMRT at our department. 122 patients (76%) were referred with primary disease and 38 patients (24%) with a recurrent OCC at least 3 months after surgery alone. Definitive IMRT was performed in 44/160 patients (28%), whilst 116 patients underwent previous surgery. Simultaneous systemic therapy was administered in 72%.
Patients with postoperative IMRT (+/−systemic therapy) with R0-1 status (n = 99) reached significantly higher LRC/OAS rates than patients following IMRT for macroscopic disease (n = 61), with 84%/80% versus 38%/33% at 3 years, respectively (p < 0.0001). This was found in patients treated for initial, as well as recurrent, disease. Less than 2% persisting grade 3/4 late effects were observed.
IMRT for R0-1 situations translated into a highly significant superior LRC and OAS compared to the IMRT cohort treated for macroscopic disease. Treatment was well tolerated.