Ipsilateral Irradiation for Oral and Oropharyngeal Carcinoma Treated With Primary Surgery and Postoperative Radiotherapy

Journal Article · Mon Nov 01 04:00:00 EDT 2010 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2009.08.042· OSTI ID:21437995

Doornaert, Patricia ^[1]; Jonkman, Anja ^[2]; Jong, Martin A. de ^[3]; Leemans, C Rene ^[4]; Slotman, Ben J ^[1]; Langendijk, Johannes A ^[2]

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1. Department of Radiation Oncology, VU University Medical Center, Amsterdam (Netherlands)
2. Department of Radiation Oncology, University Medical Center Groningen, Groningen (Netherlands)
3. Department of Radiation Oncology, Leiden University Medical Center, Leiden (Netherlands)
4. Department of Otolaryngology/Head and Neck Surgery, VU University Medical Center, Amsterdam (Netherlands)

Purpose: The purpose was to evaluate the contralateral nodal control (CLNC) in postoperative patients with oral and oropharyngeal cancer treated with ipsilateral irradiation of the neck and primary site. Late radiation-induced morbidity was also evaluated. Methods and Materials: The study included 123 patients with well-lateralized squamous cell carcinomas treated with surgery and unilateral postoperative irradiation. Most patients had tumors of the gingiva (41%) or buccal mucosa (21%). The majority of patients underwent surgery of the ipsilateral neck (n = 102 [83%]). The N classification was N0 in 73 cases (59%), N1 or N2a in 23 (19%), and N2b in 27 cases (22%). Results: Contralateral metastases developed in 7 patients (6%). The 5-year actuarial CLNC was 92%. The number of lymph node metastases was the only significant prognostic factor with regard to CLNC. The 5-year CLNC was 99% in N0 cases, 88% in N1 or N2a cases, and 73% in N2b cases (p = 0.008). Borderline significance (p = 0.06) was found for extranodal spread. Successful salvage could be performed in 71% of patients with contralateral metastases. The prevalence of Grade 2 or higher xerostomia was 2.6% at 5 years. Conclusions: Selected patients with oral or oropharyngeal carcinoma treated with primary surgery and postoperative ipsilateral radiotherapy have a very high CLNC with a high probability of successful salvage in case of contralateral metastases. However, bilateral irradiation should be applied in case of multiple lymph node metastases in the ipsilateral neck, particularly in the presence of extranodal spread. The incidence of radiation-induced morbidity is considerably lower as observed after bilateral irradiation.

• OSTI ID: 21437995
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 78; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CARCINOMAS
DIGESTIVE SYSTEM
DISEASE INCIDENCE
DISEASES
HEAD
LYMPH NODES
LYMPHATIC SYSTEM
MEDICINE
METASTASES
NECK
NEOPLASMS
NUCLEAR MEDICINE
ORGANS
PHARYNX
RADIOLOGY
RADIOTHERAPY
RESPIRATORY SYSTEM
SURGERY
THERAPY