Concurrent chemoradiotherapy compared with surgery and adjuvant radiotherapy for oral cavity squamous cell carcinoma

Head Neck. 2015 Apr;37(4):518-23. doi: 10.1002/hed.23626. Epub 2014 May 2.

Abstract

Background: The purpose of this study was to compare survival and functional outcomes in patients with advanced oral cavity squamous cell carcinoma (SCC) treated with either surgery + adjuvant radiotherapy (RT) or concurrent chemoradiotherapy (CRT).

Methods: Patients treated with curative intent by either surgery + RT or concurrent CRT were identified over a 6-year period (2001-2007). Disease and functional outcomes were analyzed on an intention-to-treat basis.

Results: Fifty-four patients underwent surgical excision and received postoperative RT. Fifty patients underwent concurrent CRT. Overall survival (OS) and disease-specific survival (DSS) was significantly higher in the surgically treated group (p < .001). Long-term enteral feeding tube support was more commonly required in those treated with CRT, whereas osteoradionecrosis rates were comparable between the 2 groups.

Conclusion: Treatment by surgery + adjuvant RT for advanced oral cavity SCC resulted in better disease control than treatment with CRT. This supports traditional surgical treatment algorithms for oral cavity cancer.

Keywords: chemoradiotherapy; feeding tube; head and neck cancer; organ preservation; osteoradionecrosis.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / prevention & control
  • Carcinoma, Squamous Cell / radiotherapy
  • Carcinoma, Squamous Cell / surgery
  • Carcinoma, Squamous Cell / therapy*
  • Chemoradiotherapy*
  • Enteral Nutrition
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / prevention & control
  • Head and Neck Neoplasms / radiotherapy
  • Head and Neck Neoplasms / surgery
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms / prevention & control
  • Mouth Neoplasms / radiotherapy
  • Mouth Neoplasms / surgery
  • Mouth Neoplasms / therapy*
  • Retrospective Studies
  • Squamous Cell Carcinoma of Head and Neck
  • Survival Analysis
  • Treatment Outcome