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Clinical outcomes and failure patterns after postoperative radiotherapy for oral cavity squamous cell carcinoma

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Abstract

Purpose

This study aimed to assess recurrence patterns and identify the optimal dose and target volumes of postoperative radiotherapy (PORT) in patients with oral cavity squamous cell carcinoma (OSCC).

Methods

Data of 111 patients who received PORT for OSCC between January 2010 and April 2020 were retrospectively reviewed. The median age was 68 years (range 19–88). PORT was administered as initial treatment to 63 patients and as salvage treatment for recurrent tumors to 48 patients. The median prescribed dose was 60 Gy (range 50–66) administered in 30 fractions (range 25–33).

Results

Median follow-up time was 73 months (range 24–147). Overall survival (OS), progression-free survival (PFS), local control (LC), and locoregional control (LRC) at 3 years were 55.6%, 45.6%, 74.6%, and 63.1%, respectively. There were no significant differences in OS, PFS, LC, and LRC between the initially diagnosed and postoperative recurrent cases. Of 22 patients (20%) who developed regional nodal recurrences, 17 (15%) and 11 (10%) had in-field and out-of-field recurrences, respectively. Of 105 patients who received irradiation to the primary tumor bed, 24 (23%) developed recurrence at the primary site. The PFS and LC rates were significantly worse in patients receiving ≤ 56 Gy to the primary site than those receiving > 56 Gy (p = 0.016 and p = 0.032, respectively).

Conclusion

PORT was effective for postoperative recurrences as well as for initially diagnosed oral cavity cancer. Doses greater than 56 Gy to the primary site may be required in PORT for OSCC.

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Acknowledgements

We thank Dr. Kenji Matsumoto from the Department of Radiology Center, Kindai University Hospital, for his guidance in revising the manuscript. The authors would like to acknowledge Editage (www.editage.jp) for English language editing.

Funding

This work was supported by JSPS KAKENHI (grant number JP22K07733 and JP20K08009).

Author information

Authors and Affiliations

  1. Department of Radiation Oncology, Kindai University Faculty of Medicine, 377-2, Osaka, Ohno-higashi, Osaka-Sayama, Japan

    Saori Tatsuno, Hiroshi Doi MD, PhD, Masahiro Inada, Takuya Uehara, Yutaro Wada, Kazuki Ishikawa & Yasumasa Nishimura

  2. Department of Medical Oncology, Kindai University Faculty of Medicine, 377-2, Osaka, Ohno-Higashi, Osaka-Sayama, Japan

    Kaoru Tanaka

  3. Department of Otolaryngology-Head and Neck Surgery, Kindai University Faculty of Medicine, 377-2, Osaka, Ohno-Higashi, Osaka-Sayama, Japan

    Mutsukazu Kitano

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  1. Saori Tatsuno
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Contributions

ST conceived this study, collected the data, analyzed the data, and drafted the manuscript. HD reviewed and edited the manuscript. KT performed the chemotherapy. MK performed the surgery. ST, HD, MI, TU, YW, KI, and YN performed the radiotherapy. YN supervised the project. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hiroshi Doi MD, PhD.

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Conflict of interest

K. Tanaka reports personal fees from AstraZeneca, Merck Serono, Ono Pharmaceutical, Bristol Myers Squibb, Eisai, and MSD outside the submitted work. S. Tatsuno, H. Doi, M. Inada, T. Uehara, Y. Wada, K. Ishikawa, M. Kitano and Y. Nishimura declare that they have no competing interests.

Ethical standards

This study was conducted in accordance with the guidelines of the Declaration of Helsinki. This study was approved by our institutional review board (approval number R02-112). Written informed consent for radiotherapy was obtained from all individual participants prior to radiotherapy. Informed consent for this study was obtained in the form of opt-out.

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Tatsuno, S., Doi, H., Inada, M. et al. Clinical outcomes and failure patterns after postoperative radiotherapy for oral cavity squamous cell carcinoma. Strahlenther Onkol 200, 389–399 (2024). https://doi.org/10.1007/s00066-023-02171-w

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