Concurrent chemotherapy and intensity-modulated radiotherapy for organ preservation of locoregionally advanced oral cavity cancer

Am J Clin Oncol. 2011 Aug;34(4):356-61. doi: 10.1097/COC.0b013e3181e8420b.

Abstract

Objectives: To report outcomes of oral cavity cancer patients treated with concurrent chemotherapy and intensity-modulated radiotherapy (chemoIMRT).

Methods: Between 2001 and 2004, 21 patients with oral cavity squamous cell carcinoma underwent definitive chemoIMRT. Sites included were oral tongue (n = 9), floor of mouth (n = 6), buccal mucosa (n = 3), retromolar trigone (n = 2), and hard palate (n = 1). Most had stage III-IV disease (n = 20). The most common regimen was 5 days infusional 5-fluorouracil (600 mg/m(2)/d × 5 days), hydroxyurea (500 mg, PO BID), and 1.5 Gy twice-daily irradiation to 72 to 75 Gy.

Results: The median follow-up for surviving patients was 60 months. Treatment failure occurred as follows: local-1, regional-1, and distant metastases-2. The 2- and 5-year estimates of locoregional progression-free survival, disease-free survival, and overall survival were 90% and 90%, 71% and 71%, and 76% and 76%, respectively. Late complications included osteoradionecrosis (3 patients, 14%).

Conclusions: Concurrent chemoIMRT results in promising locoregional control for oral cavity squamous cell carcinomas with acceptable toxicity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / drug therapy
  • Adenocarcinoma / radiotherapy
  • Adenocarcinoma / surgery
  • Adenocarcinoma / therapy*
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Carcinoma, Squamous Cell / drug therapy
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Carcinoma, Squamous Cell / therapy*
  • Clinical Trials, Phase I as Topic
  • Clinical Trials, Phase II as Topic
  • Combined Modality Therapy
  • Female
  • Fluorouracil / administration & dosage
  • Follow-Up Studies
  • Humans
  • Hydroxyurea / administration & dosage
  • Male
  • Middle Aged
  • Mouth / drug effects
  • Mouth / pathology*
  • Mouth Neoplasms / drug therapy
  • Mouth Neoplasms / radiotherapy
  • Mouth Neoplasms / surgery
  • Mouth Neoplasms / therapy*
  • Organ Preservation*
  • Quality of Life
  • Radiotherapy, Intensity-Modulated*
  • Survival Rate
  • Treatment Outcome

Substances

  • Fluorouracil
  • Hydroxyurea