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Title: Combined-modality treatment for advanced oral tongue squamous cell carcinoma

Abstract

Purpose: The aim of this study was to investigate prognostic factors in advanced-stage oral tongue cancer treated with postoperative adjuvant therapy and to identify indications for adjuvant concomitant chemoradiotherapy (CCRT). Methods and Materials: We retrospectively reviewed the records of 201 patients with advanced squamous cell carcinoma of the oral tongue managed between January 1995 and November 2002. All had undergone wide excision and neck dissection plus adjuvant radiotherapy or CCRT. Based on postoperative staging, 123 (61.2%) patients had Stage IV and 78 (38.8%) had Stage III disease. All patients were followed for at least 18 months after completion of radiotherapy or until death. The median follow-up was 40.4 months for surviving patients. The median dose of radiotherapy was 64.8 Gy (range, 58.8-72.8 Gy). Cisplatin-based regimens were used for chemotherapy. Results: The 3-year overall survival (OS) and recurrence-free survival (RFS) rates were 48% and 50.8%, respectively. Stage, multiple nodal metastases, differentiation, and extracapsular spread (ECS) significantly affected disease-specific survival on univariate analysis. On multivariate analysis, multiple nodal metastases, differentiation, ECS, and CCRT were independent prognostic factors. If ECS was present, only CCRT significantly improved survival (3-year RFS with ECS and with CCRT = 48.2% vs. without CCRT = 15%, p =more » 0.038). In the presence of other poor prognostic factors, results of the two treatment strategies did not significantly differ. Conclusions: Based on this study, ECS appears to be an absolute indication for adjuvant CCRT. CCRT can not be shown to be statistically better than radiotherapy alone in this retrospective series when ECS is not present.« less

Authors:
;  [1]; ; ; ;  [2];  [3];  [1];  [4];  [5]
  1. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taiwan (China)|[Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan (China)
  2. Department of ENT, Chang Gung Memorial Hospital, Chang Gung University, Taiwan (China)|[Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan (China)
  3. Division of Hematology/Oncology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, Taiwan (China)|[Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan (China)
  4. Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan (China)|[Department of Medical Biotechnology and Laboratory Science, Chang Gung University, Taoyuan, Taiwan (China)
  5. Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taiwan (China)|[Taipei Chang Gung Head and Neck Oncology Group, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan (China)|[Department of Nursing, Chang Gung Institute of Technology, Taiwan (China). E-mail: jtchang@adm.cgmh.org.tw
Publication Date:
OSTI Identifier:
20944687
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 67; Journal Issue: 2; Other Information: DOI: 10.1016/j.ijrobp.2006.06.026; PII: S0360-3016(06)01116-3; Copyright (c) 2007 Elsevier Science B.V., Amsterdam, Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; CHEMOTHERAPY; COMBINED THERAPY; METASTASES; MULTIVARIATE ANALYSIS; NECK; PATIENTS; RADIATION DOSES; RADIOTHERAPY; TONGUE

Citation Formats

Fan, K.-H., Lin, C.-Y., Kang, C.-J., Huang, S.-F., Chen, I.-H., Liao, C.-T., Wang, H.-M., Chen, E.Y.-C., Cheng, A.-J., and Chang, J.T.-C. Combined-modality treatment for advanced oral tongue squamous cell carcinoma. United States: N. p., 2007. Web. doi:10.1016/j.ijrobp.2006.06.026.
Fan, K.-H., Lin, C.-Y., Kang, C.-J., Huang, S.-F., Chen, I.-H., Liao, C.-T., Wang, H.-M., Chen, E.Y.-C., Cheng, A.-J., & Chang, J.T.-C. Combined-modality treatment for advanced oral tongue squamous cell carcinoma. United States. doi:10.1016/j.ijrobp.2006.06.026.
Fan, K.-H., Lin, C.-Y., Kang, C.-J., Huang, S.-F., Chen, I.-H., Liao, C.-T., Wang, H.-M., Chen, E.Y.-C., Cheng, A.-J., and Chang, J.T.-C. Thu . "Combined-modality treatment for advanced oral tongue squamous cell carcinoma". United States. doi:10.1016/j.ijrobp.2006.06.026.
@article{osti_20944687,
title = {Combined-modality treatment for advanced oral tongue squamous cell carcinoma},
author = {Fan, K.-H. and Lin, C.-Y. and Kang, C.-J. and Huang, S.-F. and Chen, I.-H. and Liao, C.-T. and Wang, H.-M. and Chen, E.Y.-C. and Cheng, A.-J. and Chang, J.T.-C.},
abstractNote = {Purpose: The aim of this study was to investigate prognostic factors in advanced-stage oral tongue cancer treated with postoperative adjuvant therapy and to identify indications for adjuvant concomitant chemoradiotherapy (CCRT). Methods and Materials: We retrospectively reviewed the records of 201 patients with advanced squamous cell carcinoma of the oral tongue managed between January 1995 and November 2002. All had undergone wide excision and neck dissection plus adjuvant radiotherapy or CCRT. Based on postoperative staging, 123 (61.2%) patients had Stage IV and 78 (38.8%) had Stage III disease. All patients were followed for at least 18 months after completion of radiotherapy or until death. The median follow-up was 40.4 months for surviving patients. The median dose of radiotherapy was 64.8 Gy (range, 58.8-72.8 Gy). Cisplatin-based regimens were used for chemotherapy. Results: The 3-year overall survival (OS) and recurrence-free survival (RFS) rates were 48% and 50.8%, respectively. Stage, multiple nodal metastases, differentiation, and extracapsular spread (ECS) significantly affected disease-specific survival on univariate analysis. On multivariate analysis, multiple nodal metastases, differentiation, ECS, and CCRT were independent prognostic factors. If ECS was present, only CCRT significantly improved survival (3-year RFS with ECS and with CCRT = 48.2% vs. without CCRT = 15%, p = 0.038). In the presence of other poor prognostic factors, results of the two treatment strategies did not significantly differ. Conclusions: Based on this study, ECS appears to be an absolute indication for adjuvant CCRT. CCRT can not be shown to be statistically better than radiotherapy alone in this retrospective series when ECS is not present.},
doi = {10.1016/j.ijrobp.2006.06.026},
journal = {International Journal of Radiation Oncology, Biology and Physics},
number = 2,
volume = 67,
place = {United States},
year = {Thu Feb 01 00:00:00 EST 2007},
month = {Thu Feb 01 00:00:00 EST 2007}
}