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Outcomes of primary radiotherapy with or without chemotherapy for advanced oral cavity squamous cell carcinoma: Systematic review
Author(s) -
Membreno Petra V.,
Luttrell Jordan B.,
Mamidala Madhu P.,
Schwartz David L.,
Hayes D. Neil,
Gleysteen John P.,
Gillespie M. Boyd
Publication year - 2021
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.26779
Subject(s) - medicine , radiation therapy , odds ratio , confidence interval , meta analysis , chemoradiotherapy , surgery , oncology
Background Surgery with adjuvant radiotherapy is the accepted standard for treatment of advanced oral cavity squamous cell carcinoma (OCSCC); however, alternative evidence suggests that definitive (chemo)radiotherapy may have similar outcomes. Methods Systematic review was performed to assess the therapeutic value of radiotherapy or chemoradiotherapy as a primary modality for treating OCSCC. Meta‐analysis of outcomes was performed between articles comparing radiotherapy and primary surgical treatment. Results Meta‐analysis showed less favorable results of radiotherapy compared to surgery: overall survival at 3‐years (odds ratio [OR] = 0.51; 95% confidence interval [CI] = 0.34–0.77) and 5‐years (OR = 0.42; 95% CI = 0.29–0.60); disease‐specific survival at 3‐years (OR = 0.55; 95% CI = 0.32–0.96) and 5‐years (OR = 0.55; 95% CI = 0.32–0.96). Odds of feeding tube dependency were higher in primary radiotherapy group (OR = 2.67; 95% CI = 1.27–5.64). Conclusions Results of this study support the current perspective favoring primary surgical treatment for OCSCC in the absence of surgical contraindications.