Does Adjuvant Radiation Therapy Improve Outcomes In pT1-3N0 Oral Cavity Cancer With Tumor-Free Margins and Perineural Invasion?

Chun Ta Liao, Joseph Tung Chieh Chang, Hung Ming Wang, Shu Hang Ng, Chuen Hsueh, Li Yu Lee, Chih Hung Lin, I. How Chen, Shiang Fu Huang, Ann Joy Cheng, Lai Chu See, Tzu Chen Yen*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

71 Scopus citations

Abstract

Purpose: The criteria for administration of adjuvant radiation therapy (RT) in oral cavity squamous cell carcinoma (OSCC) remain controversial, and it is unclear whether patients with pT1-3N0 disease benefit from adjuvant radiation in the presence of free margins and perineural invasion. The goal of this report was to determine whether this group would benefit from adjuvant radiation therapy in terms of 5-year local control rate and overall survival rate. Methods and Materials: We retrospectively reviewed our case records from January 1996 to May 2005. In all, 460 pT1-3N0 OSCC patients had tumor-free margins, of whom 68 had perineural invasion. Postoperative adjuvant RT was performed in patients with pT4 tumors, positive lymph nodes, or close margins (≤4 mm). In addition, selected OSCC patients with large pT3 tumors or perineural invasion received postoperative adjuvant RT. Local control and overall survival rates were plotted by Kaplan-Meier analysis. Results: There were no significant differences in 5-year local control (p = 0.1936) and overall survival (p = 0.5580) rates between patients with perineural invasion compared with those without. Among patients with perineural invasion, the addition of adjuvant radiotherapy did not significantly alter the 5-year local control rate (p = 0.3170) or the overall survival rate (p = 0.0935). Conclusion: Altogether, these data seem to indicate that radical surgical resection alone should be considered a sufficient treatment for OSCC patients with pT1-3N0 disease, even in the presence of perineural invasion.

Original languageEnglish
Pages (from-to)371-376
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume71
Issue number2
DOIs
StatePublished - 01 06 2008

Keywords

  • Oral cavity
  • Perineural invasion
  • Squamous cell carcinoma

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