Definitive chemoradiation for primary oral cavity carcinoma: A single institution experience

Scher, Eli D.; Romesser, Paul B.; Chen, Christine; Ho, Felix; Wuu, Yen; Sherman, Eric J.; Fury, Matthew G.; Wong, Richard J.; McBride, Sean; Lee, Nancy Y.; Riaz, Nadeem

doi:10.1016/j.oraloncology.2015.04.007

Cited by 33 publications

(49 citation statements)

References 32 publications

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“…A similar rate (5%) was reported by Gomez et al in a cohort of 35 patients from Memorial Sloan-Kettering Cancer Center receiving postoperative IMRT for oral cavity cancer [40]. In a cohort of 75 patients from the same center treated definitively by (C)RT, 6.8% developed ORN [41]. However, some series reported worse results -ranging from 18.4 to 20.7% ORN [42][43][44].…”

Section: Toxicitiessupporting

confidence: 74%

Clinical outcome and toxicity after simultaneous integrated boost IMRT in head and neck squamous cell cancer patients

et al. 2019

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Introduction: A simultaneous integrated boost (SIB) intensity modulated radiotherapy (IMRT) in patients with head and neck squamous cell carcinoma (HNSCC) allows to irradiate different target volumes to different dose levels within a single treatment session without increasing the toxicity. Aim: To analyze the outcome and toxicity of patients treated by definitive or postoperative SIB IMRT for HNSCC. Material and methods: 106 patients with HNSCC of the oral cavity (OC), oropharynx (OP), larynx (L) and hypopharynx (HP), consecutively treated at our cancer center between 3/2012 and 3/2014 were retrospectively analyzed. The prescribed SIB IMRT doses were in the postoperative setting (group A) 60-66 Gy and 53 Gy in 30-33 fractions for PTV high risk and PTV elective, respectively; and 70 Gy and 56 Gy in 35 fractions for PTV high risk and PTV elective, respectively when given as primary treatment (group B). Toxicity was consistently graded according to RTOG/EORTC scale. Results: Median follow-up duration was 31 months. Thirty (28%) patients were postoperatively irradiated (group A) and 76 (72%) patients received definitive IMRT (group B). At 3 years, loco-regional control, distant control and overall survival were 78%, 78%, 57% and 64%, 76%, 52% in the postoperative (group A) and the definitive SIB IMRT group (group B), respectively. The observed acute grade 3 toxicities were dysphagia (44%), oral and/or oropharyngeal mucositis (40%) and dermatitis (21%). Late toxicity was predominantly clinically significant xerostomia (42%), dysgeusia (23%) and dysphagia (8%). Conclusion: SIB IMRT is feasible, safe and effective in the treatment of HNSCC patients.

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Section: Toxicitiessupporting

confidence: 74%

Clinical outcome and toxicity after simultaneous integrated boost IMRT in head and neck squamous cell cancer patients

et al. 2019

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“…Scher, et al have demonstrated 37% five-year loco-regional control and 70% freedom from distant metastasis in their study on a group of 73 RMT tumor patients [19]. Our results have shown 19 patients treated with induction chemotherapy followed by radiotherapy with a three-year survival of 39%.…”

Section: Discussionsupporting

confidence: 57%

Treatment Outcomes of Rare Retromolar Trigone Squamous Cell Carcinoma Using Combined Modalities

Faisal¹,

Abbas²,

Khaleeq³

et al. 2017

Cureus

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BackgroundRetromolar trigone squamous cell carcinoma is relatively uncommon and due to its complex anatomy has always remained a challenge in terms of loco-regional control and survival. Surgery, radiotherapy, and chemotherapy as combined modalities have been used but high recurrence rates result in poor outcome.MethodsWe have retrospectively evaluated records of 62 patients treated in Head and Neck Oncology unit of Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH and RC), Lahore, Pakistan from 2004 to 2014 who were included based on the criteria of histopathological proven squamous cell carcinoma of retromolar trigone (RMT) treated with radical intent. Diagnostic workup for all patients involved clinical examination, imaging modalities usually magnetic resonance imaging (MRI), computerized tomography (CT), Orthopantomogram (OPG), and chest x-ray (CXR) to evaluate regional and distant metastasis, respectively. Kaplan-Meier survival curves were used to depict survival.ResultsThe study was comprised of 36 male and 26 female patients. Treatment modalities used are surgery only (n = 1), radiotherapy alone (n = 13), radiotherapy followed by surgery (n = 10), chemoradiotherapy (n = 16), induction chemotherapy followed by concurrent chemoradiotherapy (n = 19), induction chemotherapy followed by surgery, and radiotherapy (n = 2). Surgical interventions include wide local excisions (n = 6), marginal mandibulectomy (n = 4), and segmental mandibulectomy (n = 4). Surgical margins were clear in 54%, close in 38%, and involved in 8% of patients. AJCC 7th edition showed cT1 8%, cT2 22%, cT3 14%, and cT4 56% while pT1 2%, pT2 3%, and pT4 8%. During follow-up, 18% patients have come up with local recurrence, 22% showed persistent disease while 9% have presented with distant metastasis. The five-year and overall survivals are 38% and 22%, respectively.ConclusionRetromolar trigone involvement poses many vital structures at risk of involvement. Late presentation results in involvement of masticator space compromising both mouth opening and surgical outcomes. Surgery and radiotherapy have shown comparable results in disease control. Bone invasion has shown poor outcome in terms of loco-regional control and overall survival.

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“…A recently published report on a 20year experience of this approach demonstrated 79% locoregional control overall, with the majority of these treatment failures occurring in high-dose regions. 118 Similarly, Scher et al 119 demonstrated a 5% rate of isolated regional failure and less than 10% overall rates of regional failure, many of which were in the high-dose gross tumor nonelective region. Finally, a large Indian retrospective study included 100 patients who were treated definitively with radiotherapy for oral cavity cancer.…”

Section: Oral Cavitymentioning

confidence: 96%

Management of the Neck in Squamous Cell Carcinoma of the Oral Cavity and Oropharynx: ASCO Clinical Practice Guideline

Koyfman

Ismaila

Crook

et al. 2019

JCO

259

171

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PURPOSE The aim of the current work is to provide evidence-based recommendations to practicing physicians and others on the management of the neck in patients with squamous cell carcinoma of the oral cavity and oropharynx. METHODS ASCO convened an Expert Panel of medical oncology, surgery, radiation oncology, and advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 1990 through 2018. Outcomes of interest included survival, regional disease control, neck recurrence, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 124 relevant studies to inform the evidence base for this guideline. Six clinical scenarios were devised; three for oral cavity cancer and three for oropharynx cancer, and recommendations were generated for each one. RECOMMENDATIONS For oral cavity cancers, clinical scenarios focused on the indications for and the hallmarks of a high-quality neck dissection, indications for postoperative radiotherapy or chemoradiotherapy, and whether radiotherapy alone is sufficient elective treatment of an undissected neck compared with high-quality neck dissection. For oropharynx cancers, clinical scenarios focused on hallmarks of a high-quality neck dissection, factors that would favor operative versus nonoperative primary management, and clarifying criteria for an incomplete response to definitive chemoradiation for which salvage neck dissection would be recommended. Consensus was reached and recommendations were made for all six clinical scenarios. Additional information is available at www.asco.org/head-neck-cancer-guidelines .

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Definitive chemoradiation for primary oral cavity carcinoma: A single institution experience

Cited by 33 publications

References 32 publications

Clinical outcome and toxicity after simultaneous integrated boost IMRT in head and neck squamous cell cancer patients

Clinical outcome and toxicity after simultaneous integrated boost IMRT in head and neck squamous cell cancer patients

Treatment Outcomes of Rare Retromolar Trigone Squamous Cell Carcinoma Using Combined Modalities

Management of the Neck in Squamous Cell Carcinoma of the Oral Cavity and Oropharynx: ASCO Clinical Practice Guideline

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