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Article: IMRT in oral cavity cancer

TitleIMRT in oral cavity cancer
Authors
Issue Date2007
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.ro-journal.com
Citation
Radiation Oncology, 2007, v. 2 n. 1 How to Cite?
AbstractBackground: Except for early T1,2 N0 stages, the prognosis for patients with oral cavity cancer (OCC) is reported to be worse than for carcinoma in other sites of the head and neck (HNC). The aim of this work was to assess disease outcome in OCC following IMRT. Between January 2002 and January 2007, 346 HNC patients have been treated with curative intensity modulated radiation therapy (IMRT) at the Department of Radiation Oncology, University Hospital Zurich. Fifty eight of these (16%) were referred for postoperative (28) or definitive (30) radiation therapy of OCC. 40 of the 58 OCC patients (69%) presented with locally advanced T3/4 or recurred lesions. Doses between 60 and 70 Gy were applied, combined with simultaneous cisplatin based chemotherapy in 78%. Outcome analyses were performed using Kaplan Meier curves. In addition, comparisons were performed between this IMRT OCC cohort and historic in-house cohorts of 33 conventionally irradiated (3DCRT) and 30 surgery only patients treated over the last 10 years. Results: OCC patients treated with postoperative IMRT showed the highest local control (LC) rate of all assessed treatment sequence subgroups (92% LC at 2 years). Historic postoperative 3DCRT patients and patients treated with surgery alone reached LC rates of ∼70-80%. Definitively irradiated patients revealed poorest LC rates with ∼30 and 40% following 3DCRT and IMRT, respectively. T1 stage resulted in an expectedly significantly higher LC rate (95%, n = 19, p < 0.05) than T2-4 and recurred stages (LC ∼50-60%, n = 102). Analyses according to the diagnosis revealed significantly lower LC in OCC following definitive IMRT than that in pharyngeal tumors treated with definitive IMRT in the same time period (43% vs 82% at 2 years, p < 0.0001), while the LC rate of OCC following postoperative IMRT was as high as in pharyngeal tumors treated with postoperative IMRT (<90% at 2 years). Conclusion: Postoperative IMRT of OCC resulted in the highest local control rate of the assessed treatment subgroups. In conclusion, generous indication for IMRT following surgical treatment is recommended in OCC cases with unfavourable features like tight surgical margin, nodal involvement, primary tumor stage
Persistent Identifierhttp://hdl.handle.net/10722/154459
ISSN
2015 Impact Factor: 2.466
2015 SCImago Journal Rankings: 1.278
ISI Accession Number ID
Funding AgencyGrant Number
Zurich Cancer League
Funding Information:

Financial support: This work was in part supported by the 'Zurich Cancer League'

References

 

DC FieldValueLanguage
dc.contributor.authorStuder, Gen_US
dc.contributor.authorZwahlen, RAen_US
dc.contributor.authorGraetz, KWen_US
dc.contributor.authorDavis, BJen_US
dc.contributor.authorGlanzmann, Cen_US
dc.date.accessioned2012-08-08T08:25:26Z-
dc.date.available2012-08-08T08:25:26Z-
dc.date.issued2007en_US
dc.identifier.citationRadiation Oncology, 2007, v. 2 n. 1en_US
dc.identifier.issn1748-717Xen_US
dc.identifier.urihttp://hdl.handle.net/10722/154459-
dc.description.abstractBackground: Except for early T1,2 N0 stages, the prognosis for patients with oral cavity cancer (OCC) is reported to be worse than for carcinoma in other sites of the head and neck (HNC). The aim of this work was to assess disease outcome in OCC following IMRT. Between January 2002 and January 2007, 346 HNC patients have been treated with curative intensity modulated radiation therapy (IMRT) at the Department of Radiation Oncology, University Hospital Zurich. Fifty eight of these (16%) were referred for postoperative (28) or definitive (30) radiation therapy of OCC. 40 of the 58 OCC patients (69%) presented with locally advanced T3/4 or recurred lesions. Doses between 60 and 70 Gy were applied, combined with simultaneous cisplatin based chemotherapy in 78%. Outcome analyses were performed using Kaplan Meier curves. In addition, comparisons were performed between this IMRT OCC cohort and historic in-house cohorts of 33 conventionally irradiated (3DCRT) and 30 surgery only patients treated over the last 10 years. Results: OCC patients treated with postoperative IMRT showed the highest local control (LC) rate of all assessed treatment sequence subgroups (92% LC at 2 years). Historic postoperative 3DCRT patients and patients treated with surgery alone reached LC rates of ∼70-80%. Definitively irradiated patients revealed poorest LC rates with ∼30 and 40% following 3DCRT and IMRT, respectively. T1 stage resulted in an expectedly significantly higher LC rate (95%, n = 19, p < 0.05) than T2-4 and recurred stages (LC ∼50-60%, n = 102). Analyses according to the diagnosis revealed significantly lower LC in OCC following definitive IMRT than that in pharyngeal tumors treated with definitive IMRT in the same time period (43% vs 82% at 2 years, p < 0.0001), while the LC rate of OCC following postoperative IMRT was as high as in pharyngeal tumors treated with postoperative IMRT (<90% at 2 years). Conclusion: Postoperative IMRT of OCC resulted in the highest local control rate of the assessed treatment subgroups. In conclusion, generous indication for IMRT following surgical treatment is recommended in OCC cases with unfavourable features like tight surgical margin, nodal involvement, primary tumor stage <T1N0, or already recurred disease, respectively. Loco-regional outcome of OCC following definitive IMRT remained unsatisfactory, comparable to that following definitive 3DCRT. © 2007 Studer et al; licensee BioMed Central Ltd.en_US
dc.languageengen_US
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.ro-journal.comen_US
dc.relation.ispartofRadiation Oncologyen_US
dc.subject.meshAgeden_US
dc.subject.meshCohort Studiesen_US
dc.subject.meshCombined Modality Therapyen_US
dc.subject.meshDisease-Free Survivalen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshImaging, Three-Dimensionalen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMouth Neoplasms - Drug Therapy - Radiotherapyen_US
dc.subject.meshPrognosisen_US
dc.subject.meshRadiotherapy, Intensity-Modulated - Methodsen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshTime Factorsen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleIMRT in oral cavity canceren_US
dc.typeArticleen_US
dc.identifier.emailZwahlen, RA:zwahlen@hku.hken_US
dc.identifier.authorityZwahlen, RA=rp00055en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1186/1748-717X-2-16en_US
dc.identifier.pmid17430599-
dc.identifier.scopuseid_2-s2.0-34248392974en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-34248392974&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume2en_US
dc.identifier.issue1en_US
dc.identifier.isiWOS:000260303300001-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridStuder, G=16231684900en_US
dc.identifier.scopusauthoridZwahlen, RA=7004217269en_US
dc.identifier.scopusauthoridGraetz, KW=16306904700en_US
dc.identifier.scopusauthoridDavis, BJ=7403922286en_US
dc.identifier.scopusauthoridGlanzmann, C=7005122985en_US
dc.identifier.citeulike1223199-

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