Outcome and patterns of failure after postoperative intensity modulated radiotherapy for locally advanced or high-risk oral cavity squamous cell carcinoma

Radiation Oncology

Pirus Ghadjar⁴  Daniel M Aebersold⁴  Wock Hallermann³  Peter Manser⁴  Andreas Arnold²  Susanne Crowe¹  Beat Bojaxhiu⁴  Andreas Geretschläger⁴ 

[1] SAKK Coordinating Center, Effingerstrasse 40, 3008, Bern, Switzerland;Department of Otorhinolaryngology, University Hospital Bern, Freiburgstrasse, 3010, Bern, Switzerland;Department of Craniomaxillofacial Surgery, University Hospital Bern, Freiburgstrasse, 3010, Bern, Switzerland;Department of Radiation Oncology and Division of Medical Radiation Physics, Bern University Hospital, Freiburgstrasse, 3010, Bern, Switzerland

关键词: Postoperative;    Outcome;    Oral cavity;    IMRT;    Head and neck cancer;   

Others  :  1155189
DOI  :  10.1186/1748-717X-7-175

 received in 2012-07-25, accepted in 2012-10-17,  发布年份 2012

【 摘 要 】

Background

To determine the outcome and patterns of failure in oral cavity cancer (OCC) patients after postoperative intensity modulated radiotherapy (IMRT) with concomitant systemic therapy.

Methods

All patients with locally advanced (AJCC stage III/IV) or high-risk OCC (AJCC stage II) who underwent postoperative IMRT at our institution between December 2006 and July 2010 were retrospectively analyzed. The primary endpoint was locoregional recurrence-free survival (LRRFS). Secondary endpoints included distant metastasis-free survival (DMFS), overall survival (OS), acute and late toxicities.

Results

Overall 53 patients were analyzed. Twenty-three patients (43%) underwent concomitant chemotherapy with cisplatin, two patients with carboplatin (4%) and four patients were treated with the monoclonal antibody cetuximab (8%).

At a median follow-up of 2.3 (range, 1.1–4.6) years the 3-year LRRFS, DMFS and OS estimates were 79%, 90%, and 73% respectively. Twelve patients experienced a locoregional recurrence. Eight patients, 5 of which had both a flap reconstruction and extracapsular extension (ECE), showed an unusual multifocal pattern of recurrence. Ten locoregional recurrences occurred marginally or outside of the high-risk target volumes. Acute toxicity grades of 2 (27%) and 3 (66%) and late toxicity grades of 2 (34%) and 3 (11%) were observed.

Conclusion

LRRFS after postoperative IMRT is satisfying and toxicity is acceptable. The majority of locoregional recurrences occurred marginally or outside of the high-risk target volumes. Improvement of high-risk target volume definition especially in patients with flap reconstruction and ECE might transfer into better locoregional control.

【 授权许可】

   
2012 Geretschläger et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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