Skip to main content

Advertisement

SpringerLink
Log in

Role of Adjuvant Radiotherapy in Early Stage Tongue Cancer: Need for Establishing Stringent Guidelines

  • Original Article
  • Published:
Indian Journal of Surgical Oncology Aims and scope Submit manuscript

Abstract

The primary objective of this study was to determine, using population-based data, whether the addition of postoperative radiotherapy (RT) provides an overall survival benefit in patients with early primary squamous cell carcinoma (SCC) of tongue. The study included the data of tongue cancer patients treated between January 2016 and July 2019 retrieved from our hospital database. Tumours limited to pathologic T1 and T2 category managed with primary surgery with or without postoperative external beam RT were included. Overall survival (OS) and disease-free survival (DFS) were the main outcomes of interest. A total of 211 cases of oral cancer were evaluated and all the patients had clear surgical and pathological margins. Postoperative adjuvant therapy (PORT) was received by 16 patients. Comparison of DFS and OS at 2-year follow-up depicted a similar outcome (p = 0.582 and p = 0.312 respectively). Findings from our study suggest that in the absence of any absolute advantage on quantifiable survival and disease control, it is necessary to define stringent criteria when advocating PORT in early tongue cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Fridman E, Na’ara S, Agarwal J et al (2018) The role of adjuvant treatment in early-stage oral cavity squamous cell carcinoma: an international collaborative study. Cancer 124(14):2948–2955. https://doi.org/10.1002/cncr.31531

    Article  PubMed  Google Scholar 

  2. Cheng HS, Liu SA, Lin JC (2020) Survival outcome and prognostic factor analyses in early tongue cancer patients treated with surgery alone. Ther Radiol Oncol 4:7

    Article  Google Scholar 

  3. Shim SJ, Cha J, Koom WS et al (2010) Clinical outcomes for T1-2N0-1 oral tongue cancer patients underwent surgery with and without postoperative radiotherapy. Radiat Oncol 5:43. https://doi.org/10.1186/1748-717X-5-43

    Article  PubMed  PubMed Central  Google Scholar 

  4. Subash A, Rao VUS (2018) Are adjuvant radiotherapy outcomes really better in patients with early-stage oral cavity squamous cell carcinoma? Cancer 124(23):4577–4578. https://doi.org/10.1002/cncr.31797

    Article  PubMed  Google Scholar 

  5. Ebrahimi A, Gil Z, Amit M et al (2019) Depth of invasion alone as an indication for postoperative radiotherapy in small oral squamous cell carcinomas: An International Collaborative Study. Head Neck 41(6):1935–1942. https://doi.org/10.1002/hed.25633

    Article  PubMed  PubMed Central  Google Scholar 

  6. Fridman E, Na’ara S, Gil Z (2018) Reply to Are adjuvant radiotherapy outcomes really better in patients with early-stage oral cavity squamous cell carcinoma? Cancer 124(23):4578–4579. https://doi.org/10.1002/cncr.31796

    Article  PubMed  Google Scholar 

  7. Rubin SJ, Gurary EB, Qureshi MM et al (2019) Stage II oral tongue cancer: survival impact of adjuvant radiation based on depth of invasion. Otolaryngol Head Neck Surg 160(1):77–84. https://doi.org/10.1177/0194599818779907

    Article  PubMed  Google Scholar 

  8. Brown JS, Shaw RJ, Bekiroglu F, Rogers SN (2012) Systematic review of the current evidence in the use of postoperative radiotherapy for oral squamous cell carcinoma. Br J Oral Maxillofac Surg 50:481–489

    Article  CAS  Google Scholar 

  9. So YK, Oh D, Choi N, Baek CH, Ahn YC, Chung MK (2018) Efficacy of postoperative neck irradiation for regional control in patients with pN0 oral tongue cancer: Propensity analysis. Head Neck 40(1):163–169. https://doi.org/10.1002/hed.24980

    Article  PubMed  Google Scholar 

  10. Amin MB, Edge S, Greene F et al (eds) (2017) AJCC Cancer Staging Manual, 8th edition. Springer International Publishing American Joint Commission on Cancer, Chicago

    Google Scholar 

  11. Pinsolle J, Pinsolle V, Majoufre C et al (1997) Prognostic value of histologic findings in neck dissections for squamous cell carcinoma. Arch Otolaryn- gol Head Neck Surg 123(2):145–148

    Article  CAS  Google Scholar 

  12. Thiagarajan S, Nair S, Nair D, Chaturvedi P, Kane SV, Agarwal JP, D’Cruz AK (2014) Predictors of prognosis for squamous cell carcinoma of oral tongue. J Surg Oncol 109:639–644. https://doi.org/10.1002/jso.23583

    Article  PubMed  Google Scholar 

  13. Fakih AR, Rao RS, Borges AM, Patel AR (1989) Elective versus therapeutic neck dissection in early carcinoma of the oral tongue. Am J Surg 158(4):309–313. https://doi.org/10.1016/0002-9610(89)90122-0

    Article  PubMed  CAS  Google Scholar 

  14. Howlader N, Noone A, Krapcho M et al (2012) SEER cancer statistics review 1975–2010. Bethesda: National Cancer Institute. Available at: http://seer.cancer.gov/statfacts/html/tongue.html. Accessed 21 April 2013

  15. Best CAE, Quimby AE, Best BAB, Fergusson D, Alsaffar H (2019) Evaluating the effectiveness of adjuvant radiotherapy in addition to surgery versus surgery alone at improving oncologic outcomes for early stage buccal carcinoma: a systematic review [published correction appears in J Otolaryngol Head Neck Surg. 2020;49(1):5]. J Otolaryngol Head Neck Surg. 2019;48(1):73. https://doi.org/10.1186/s40463-019-0396-x

Download references

Author information

Authors and Affiliations

  1. Department of Head and Neck Oncology, HCG Cancer Centre, Sampangi Ram Nagar, Bengaluru, Karnataka, India, 560020

    Vishal Rao, Anand Subash, Piyush Sinha, Sameep Shetty, Shalini Thakur, Yash Merchant, Akshay Kudpaje & Gururaj Arakeri

  2. Centre for Academic Research, HCG Cancer Centre, Bengaluru, India

    Vishal Rao, Anand Subash, Piyush Sinha, Sameep Shetty, Shalini Thakur, Yash Merchant, Akshay Kudpaje & Gururaj Arakeri

Authors
  1. Vishal Rao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anand Subash
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Piyush Sinha
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Sameep Shetty
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shalini Thakur
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yash Merchant
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Akshay Kudpaje
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Gururaj Arakeri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anand Subash.

Ethics declarations

Ethics Approval and Consent to Participate

HCG Cancer Centre IRB and Ethics Committee cleared the study.

Conflict of Interest

The authors declare no competing interests.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Level of Evidence: Retrospective Cohort Study (3)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rao, V., Subash, A., Sinha, P. et al. Role of Adjuvant Radiotherapy in Early Stage Tongue Cancer: Need for Establishing Stringent Guidelines. Indian J Surg Oncol 12, 549–553 (2021). https://doi.org/10.1007/s13193-021-01379-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13193-021-01379-5

Keywords

Search

Navigation