Surgery and postoperative radiotherapy a valid treatment for advanced oropharyngeal carcinoma

Abstract

Since 1992 we have prospectively included all head and neck cancer patients in our health region in a departmental based register. Our hospital takes care of all head and neck cancer patients in our health region consisting of approximately 1 million people. In 1997, we evaluated the results of the treatment of oropharyngeal cancer in the 1992–1997 period. On the basis of this evaluation, we changed our treatment policy for tonsillar and base of tongue carcinoma. We first changed the treatment for the lesions with worst prognosis, i.e., those with T3–T4 carcinomas, from radiotherapy only, to radical surgery and postoperative radiotherapy. We have since that time increasingly also operated the smaller oropharyngeal carcinomas. The 2 years’ overall survival and disease-specific survival for all patients diagnosed in the 1992–1997 period was 56 and 63%, respectively. The results from a similar group of patients in the 6 years’ period from 2000 to 2005, after the change in treatment, have increased to 83 and 88%. When we looked at the subgroup of patients in the 2000–2005 period treated with surgery and postoperative radiotherapy, 45 out of 69 patients (65%) presenting with an oropharyngeal cancer were fit for operation. With radical surgery and postoperative radiation therapy, the 2 years overall survival is now 91%. The 2-year disease-specific survival is 96% and the locoregional control is 98%. This is a marked improvement as compared to radiotherapy alone and definitely competitive with modern radiochemotherapy.

Survival and Prognostic Factors of Different Sites of Head and Neck Cancer: An Analysis from Thailand

“…The increase in survival rates during the years for these cancers is thought to be due to the increased combined surgery and radiation modality (21% to 34%). The vast improvement in the survival rate of oropharynx cancer patients from the increase in combined surgery and radiation rather than radiation alone is also reported in European countries (Mäkitie et al, 2009;Lybak et al, 2011). The smaller proportion of patients receiving this combined treatment could be one of the reasons contributing the poor survival in our series.…”

“…Also, the proportion of patients treated with surgery plus radiation is lower than the aforementioned series stated (Carvalho et al, 2005;Barzan et al, 2002). This combined treatment has been shown to improve locoregional control and overall survival for locally advanced HNCA (Mäkitie et al, 2006;Lybak et al, 2011). This indicates that our patients did not receive the treatment option that should be received according to their stage of disease.…”

Overall Survival of Filipino Patients with Squamous Cell Carcinoma of the Head and Neck: A Single-Institution Experience

“…In our study, 32 (74.4%) of the 43 T1 or T2 cases were able to undergo this recommended treatment. While chemotherapy is recommended for T3, T4a, and T4b stages (Lybak et al, 2011), none of our cases was able to avail said treatment, again due to financial constraints.…”

Pain management during radiotherapy and radiochemotherapy in oropharyngeal cancer patients: single-institution experience

“…Radiotherapy (RT) alone is used in early to advanced stages of OPC. There are several treatment approaches for patients with OPC who present in intermediate or advanced stages of the disease: surgery followed by adjuvant RT or concurrent radiochemotherapy (RT‐CT); definitive RT or RT‐CT, followed by definitive RT‐CT induction chemotherapy; and RT combined with a monoclonal antibody directed to epidermal growth factor receptor (EGFR) . RT alone, or RT combined with CT or monoclonal antibody therapy, is known to induce significant side effects.…”