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Efficacy and safety of treating T4 oral cavity tumors with primary chemoradiotherapy
Author(s) -
Cohen Ezra E. W.,
Baru Joshua,
Huo Dezheng,
Haraf Daniel J.,
Crowley Maureen,
Witt Mary Ellyn,
Blair Elizabeth A.,
Weichselbaum Ralph R.,
Rosen Fred,
Vokes Everett E.,
Stenson Kerstin
Publication year - 2009
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.21062
Subject(s) - medicine , osteoradionecrosis , chemoradiotherapy , radiation therapy , surgery , primary tumor , complication , head and neck cancer , toxicity , oncology , cancer , metastasis
Abstract Background Patients with T4 oral cavity (OC) tumors are often treated with surgery followed by adjuvant chemoradiotherapy (CRT). Methods We performed a retrospective review of 4 multi‐institutional phase II studies estimating long‐term toxicity, locoregional control (LC), progression‐free survival (PFS), and overall survival (OS) of primary CRT. Results Thirty‐nine subjects were identified; 16 (42%) with bony involvement. Median radiotherapy dose delivered to primary tumor was 74 Gy. Five‐year OS, PFS, and LC rates were 56%, 51%, and 75%, respectively. Sixty‐nine percent of subjects with bony involvement never relapsed. Seven subjects developed osteoradionecrosis. Bone involvement with primary tumor did not appear to be associated with increased risk of death, relapse, or long‐term complication. Conclusion These data suggest that primary CRT is an effective treatment approach in patients with T4 OC tumors including those with bony involvement producing LC, survival, and complication rates comparable to historical series. Prospective clinical trials should evaluate primary surgical versus CRT treatment in these patients. © 2009 Wiley Periodicals, Inc. Head Neck, 2009