Post-operative radiation therapy for advanced-stage oropharyngeal cancer

Abstract

Between 1985 and 1999, 43 patients with locally-advanced, resectable oropharyngeal cancer were treated with combined surgery and post-operative radiation therapy (RT) at Oregon Health and Science University. Five patients (12 per cent) had Stage III disease and 38 patients (88 per cent) had Stage IV disease. All patients had gross total resections of the primary tumour. Thirty-seven patients had neck dissections for regional disease. RT consisted of a mean tumour-bed dose of 63.0 Gy delivered in 1.8-2.0 Gy fractions over a mean of 49 days. At three- and five-years, the actuarial local control was 96 per cent and the actuarial local/regional control was 80 per cent. The three- and five-year actuarial rates of distant metastases were 41 per cent and 46 per cent, respectively. The actuarial overall survival at three- and five-years was 41 per cent and 34 per cent, respectively. The actuarial rates of progression-free survival were 49 per cent at three-years and 45 per cent at five years. Combined surgery and post-operative RT for advanced-stage oropharyngeal cancer results in excellent local/regional control. This particular group of patients experienced a high-rate of developing distant metastases.

Swallowing Function and Tracheotomy Dependence After Combined‐Modality Treatment Including Free Tissue Transfer for Advanced‐Stage Oropharyngeal Cancer

“…Surgery and postoperative irradiation for advanced stage (stages III and IV) carcinoma of the oropharynx is an accepted treatment modality that can provide excellent local and locoregional control. In a recent study from our institution, Hansen et al 2 demonstrated that this combined treatment yielded, at 5 years, a 96% local control and 80% locoregional control, comparable with previously reported results. 3 …”

“…Surgery and postoperative irradiation combined is a commonly used treatment approach, with good local and regional control and acceptable long‐term survival. 2,3 Organ‐preservation protocols, including various combinations of chemotherapy and radiation therapy, have more recently been introduced in attempts to address the risk of distant metastases, as well as locoregional disease, and also to potentially reduce functional and cosmetic morbidities thought to be associated with surgery. 4 However, functional outcome after surgical treatment for advanced oropharyngeal carcinoma is not uniformly agreed on, and there is no clear consensus on typical postoperative outcomes.…”

Immunohistochemical evaluation of D2-40, Galectin-3, Maspin and MCM7 expression in palate squamous cell carcinomas

“…Although rare, palate SCC appear to have increased local aggressively, easily invading adjacent muscle and bone structures and thereby leaving behind important morpho-functional defects [ 14 ]. In addition, the tumors developed at the level of the soft palate seem to be much more aggressive, the five-year overall survival rate dropping from 91% for the T1 tumors [ 15 ] to 33% in the case of T4 tumors [ 16 ]. Considering these particularities, in the present study, we investigated the IHC expression of the D2-40, Gal-3, Maspin and MCM7 immunomarkers, knowing that they play a major role in promoting loco-regional cancer invasiveness.…”

Analysis of the distribution and expression of some tumor invasiveness markers in palate squamous cell carcinomas

“…The soft palate SCCs are aggressive tumors, with rapid onset and a major negative impact regardless of tumor size at diagnosis [ 26 ]. For the T1 and T2 soft palate SCCs was reported a five-year overall survival rate about 91% to 100% and respectively 70% to 75% [ 27 ], while for the T3 and T4 lesions despite multimodal treatment the rate values dropped to 33% to 47% [ 28 , 29 ]. The incidence of LN metastases for soft palate SCCs was estimated to be around 20% for T1–T2 tumors and about 60% to 70% for T3–T4 tumors [ 30 ].…”