The failure patterns of oral cavity squamous cell carcinoma after intensity-modulated radiotherapy-the university of iowa experience

Min Yao; Kristi Chang; Gerry F Funk; Heming Lu; Huaming Tan; Judith Wacha; Kenneth J Dornfeld; John M Buatti

doi:10.1016/j.ijrobp.2006.11.030

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The failure patterns of oral cavity squamous cell carcinoma after intensity-modulated radiotherapy-the university of iowa experience

Journal article

Peer reviewed

The failure patterns of oral cavity squamous cell carcinoma after intensity-modulated radiotherapy-the university of iowa experience

Min Yao, Kristi Chang, Gerry F Funk, Heming Lu, Huaming Tan, Judith Wacha, Kenneth J Dornfeld and John M Buatti

International journal of radiation oncology, biology, physics, Vol.67(5), pp.1332-1341

04/01/2007

DOI: 10.1016/j.ijrobp.2006.11.030

PMID: 17276613

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Abstract

Determine the failure patterns of oral cavity squamous cell carcinoma (SCC) treated with intensity-modulated radiotherapy (IMRT). Between May 2001 and July 2005, 55 patients with oral cavity SCC were treated with IMRT for curative intent. Forty-nine received postoperative IMRT, 5 definitive IMRT, and 1 neoadjuvant. Three target volumes were defined (clinical target CTV1, CTV2, and CTV3). The failure patterns were determined by coregistration or comparison of the treatment planning computed tomography to the images obtained at the time of recurrence. The median follow-up for all patients was 17.1 months (range, 0.27-59.3 months). The median follow-up for living patients was 23.9 months (range, 9.3-59.3 months). Nine patients had locoregional failures: 4 local failures only, 2 regional failures only, and 3 had both local and regional failures. Five patients failed distantly; of these, 3 also had locoregional failures. The 2-year overall survival, disease-specific survival, local recurrence-free survival, locoregional recurrence-free survival, and distant disease-free survival was 68%, 74%, 85%, 82%, and 89%, respectively. The median time from treatment completion to locoregional recurrence was 4.1 months (range, 3.0-12.1 months). Except for 1 patient who failed in contralateral lower neck outside the radiation field, all failed in areas that had received a high dose of radiation. The locoregional control is strongly correlated with extracapsular extension. Intensity-modulated RT is effective for oral cavity SCC. Most failures are in-field failures. Further clinical studies are necessary to improve the outcomes of patients with high-risk features, particularly for those with extracapsular extension.

Neoplasm Invasiveness

Humans

Middle Aged

Male

Carcinoma, Squamous Cell - diagnostic imaging

Carcinoma, Squamous Cell - radiotherapy

Mouth Neoplasms - mortality

Neoplasms, Second Primary - etiology

Radiography

Carcinoma, Squamous Cell - mortality

Treatment Failure

Aged, 80 and over

Adult

Carcinoma, Squamous Cell - secondary

Female

Mouth Neoplasms - radiotherapy

Aged

Neoplasms, Second Primary - diagnostic imaging

Retrospective Studies

Radiotherapy, Intensity-Modulated

Details

Title: Subtitle: The failure patterns of oral cavity squamous cell carcinoma after intensity-modulated radiotherapy-the university of iowa experience
Creators: Min Yao - Department of Radiation Oncology, University of Iowa Health Care, Iowa City, IA 52242, USA. min-yao@uiowa.edu
Kristi Chang
Gerry F Funk
Heming Lu
Huaming Tan
Judith Wacha
Kenneth J Dornfeld
John M Buatti
Resource Type: Journal article
Publication Details: International journal of radiation oncology, biology, physics, Vol.67(5), pp.1332-1341
DOI: 10.1016/j.ijrobp.2006.11.030
PMID: 17276613
NLM abbreviation: Int J Radiat Oncol Biol Phys
ISSN: 0360-3016
eISSN: 1879-355X
Publisher: Elsevier Inc; United States
Language: English
Date published: 04/01/2007
Academic Unit: Radiation Oncology; Neurosurgery; Otolaryngology
Record Identifier: 9984007198002771

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