Postoperative brachytherapy alone for 217 patients with early-stage oral cavity squamous cell carcinoma
Introduction: Postoperative radiotherapy is generally recommended for pT1/2pN0 squamous cell carcinoma of the oral cavity (OSCC) if risk factors are present. Prospective studies are missing. Interventional radiotherapy offers a precise dose application. In this paper we analyze long-term efficacy an...
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Elsevier
2025-03-01
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| Series: | Clinical and Translational Radiation Oncology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2405630825000126 |
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| author | C. Schweizer V. Strnad M. Lotter S. Kreppner R. Merten R. Fietkau A. Karius |
| author_facet | C. Schweizer V. Strnad M. Lotter S. Kreppner R. Merten R. Fietkau A. Karius |
| author_sort | C. Schweizer |
| collection | DOAJ |
| description | Introduction: Postoperative radiotherapy is generally recommended for pT1/2pN0 squamous cell carcinoma of the oral cavity (OSCC) if risk factors are present. Prospective studies are missing. Interventional radiotherapy offers a precise dose application. In this paper we analyze long-term efficacy and toxicity in a large single-center cohort of patients with early OSCC receiving sole postoperative brachytherapy (BT). Material and methods: From 1998 to 2023, 217 patients were postoperatively treated with sole BT in our institute. The median follow-up was 110 months (range: 2–316). The primary objective was local control. Secondary outcomes were overall survival, cancer specific survival, and toxicity. Results: The local recurrence rates for 12, 24, and 60 months were 7.1 %, 9.1 %, and 12.6 %. The disease-free survival was 89.7 %, 86.1 %, and 79.3 %. The overall survival rates at 12, 24, and 60 months were 94.4 %, 89.6 %, and 77.9 %. The cancer-specific survival was 97.1 %, 96.6 %, and 92.9 %, respectively. At two years, the rate of regional recurrence was 8.3 %. Patients without neck dissection had a significantly increased risk for lymph node recurrence (p = 0.025). Side effects ≥ grade 3 were seen in 14 % (30/217). 17 % (37/217) of patients developed a soft tissue necrosis (STN). Osteoradionecrosis (ORN) was seen in 7 % (15/217) of patients. A target volume > 15 cm3 was significantly associated with the occurrence of STN (p = 0.011) and ORN (p = 0.004). Conclusions: Postoperative interventional radiotherapy for previously not irradiated patients with early-stage OSCC is a safe and efficient treatment. Randomized trials are needed to compare these results to omission of postoperative radiotherapy as well as external beam radiotherapy. |
| format | Article |
| id | doaj-art-89ab49c5b1274c7f95e524068b89bd8f |
| institution | Kabale University |
| issn | 2405-6308 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
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| series | Clinical and Translational Radiation Oncology |
| spelling | doaj-art-89ab49c5b1274c7f95e524068b89bd8f2025-01-30T05:14:32ZengElsevierClinical and Translational Radiation Oncology2405-63082025-03-0151100922Postoperative brachytherapy alone for 217 patients with early-stage oral cavity squamous cell carcinomaC. Schweizer0V. Strnad1M. Lotter2S. Kreppner3R. Merten4R. Fietkau5A. Karius6Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, Germany; Corresponding author at: Universitätsklinikum Erlangen, Department of Radiation Oncology, Universitätsstr. 27, 91054 Erlangen, Germany.Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, GermanyDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, GermanyDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, GermanyDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, GermanyDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, GermanyDepartment of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany; Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen, GermanyIntroduction: Postoperative radiotherapy is generally recommended for pT1/2pN0 squamous cell carcinoma of the oral cavity (OSCC) if risk factors are present. Prospective studies are missing. Interventional radiotherapy offers a precise dose application. In this paper we analyze long-term efficacy and toxicity in a large single-center cohort of patients with early OSCC receiving sole postoperative brachytherapy (BT). Material and methods: From 1998 to 2023, 217 patients were postoperatively treated with sole BT in our institute. The median follow-up was 110 months (range: 2–316). The primary objective was local control. Secondary outcomes were overall survival, cancer specific survival, and toxicity. Results: The local recurrence rates for 12, 24, and 60 months were 7.1 %, 9.1 %, and 12.6 %. The disease-free survival was 89.7 %, 86.1 %, and 79.3 %. The overall survival rates at 12, 24, and 60 months were 94.4 %, 89.6 %, and 77.9 %. The cancer-specific survival was 97.1 %, 96.6 %, and 92.9 %, respectively. At two years, the rate of regional recurrence was 8.3 %. Patients without neck dissection had a significantly increased risk for lymph node recurrence (p = 0.025). Side effects ≥ grade 3 were seen in 14 % (30/217). 17 % (37/217) of patients developed a soft tissue necrosis (STN). Osteoradionecrosis (ORN) was seen in 7 % (15/217) of patients. A target volume > 15 cm3 was significantly associated with the occurrence of STN (p = 0.011) and ORN (p = 0.004). Conclusions: Postoperative interventional radiotherapy for previously not irradiated patients with early-stage OSCC is a safe and efficient treatment. Randomized trials are needed to compare these results to omission of postoperative radiotherapy as well as external beam radiotherapy.http://www.sciencedirect.com/science/article/pii/S2405630825000126Early-stage oral cavity cancerPostoperative radiotherapyInterventional radiotherapyLong-term toxicity after brachytherapyHDRPDR |
| spellingShingle | C. Schweizer V. Strnad M. Lotter S. Kreppner R. Merten R. Fietkau A. Karius Postoperative brachytherapy alone for 217 patients with early-stage oral cavity squamous cell carcinoma Clinical and Translational Radiation Oncology Early-stage oral cavity cancer Postoperative radiotherapy Interventional radiotherapy Long-term toxicity after brachytherapy HDR PDR |
| title | Postoperative brachytherapy alone for 217 patients with early-stage oral cavity squamous cell carcinoma |
| title_full | Postoperative brachytherapy alone for 217 patients with early-stage oral cavity squamous cell carcinoma |
| title_fullStr | Postoperative brachytherapy alone for 217 patients with early-stage oral cavity squamous cell carcinoma |
| title_full_unstemmed | Postoperative brachytherapy alone for 217 patients with early-stage oral cavity squamous cell carcinoma |
| title_short | Postoperative brachytherapy alone for 217 patients with early-stage oral cavity squamous cell carcinoma |
| title_sort | postoperative brachytherapy alone for 217 patients with early stage oral cavity squamous cell carcinoma |
| topic | Early-stage oral cavity cancer Postoperative radiotherapy Interventional radiotherapy Long-term toxicity after brachytherapy HDR PDR |
| url | http://www.sciencedirect.com/science/article/pii/S2405630825000126 |
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