Postoperative radiation therapy for squamous cell carcinomas of the oral cavity and oropharynx: Impact of therapy on patients with positive surgical margins Journal Article
| Authors: | Zelefsky, M. J.; Harrison, L. B.; Fass, D. E.; Armstrong, J. G.; Shah, J. P.; Strong, E. W. |
| Article Title: | Postoperative radiation therapy for squamous cell carcinomas of the oral cavity and oropharynx: Impact of therapy on patients with positive surgical margins |
| Abstract: | Purpose: The presence of a positive or close margin after resection of a squamous cancer of the head and neck is associated with a significant risk of local recurrence. To determine the efficacy of postoperative radiation therapy for patients with advanced oral cavity and oropharyngeal cancers with inadequate margins of resection, the present retrospective analysis was undertaken. Methods and Materials: One hundred and two patients were treated with surgery and postoperative radiation therapy for advanced squamous cell carcinomas of the oral cavity and oropharynx. The anatomic subsites treated include oral tongue (n = 29), floor of mouth (n = 22), base of tongue (n = 31) and tonsillar fossa (n = 20). Twentyfive patients (25%) had positive margins, 41 patients (40%) had close argins (≤ 0.5 cm from the surgical margin) and 36 (35%) had negative margins. The median radiation dose was 6000 cGy. Results: With a median follow-up of 7 years, the actuarial control rate for patients with positive, close and negative margins was 79%, 71%, and 79%, respectively. When postoperative doses of ≫ 60 Gy were delivered to patients with positive/close margins (excluding patients with oral tongue lesions), the 7-year actuarial control was 92%. In similar patients receiving < 60 Gy, the actuarial control was 44% (p = 0.0007). Compared to other anatomic subsites, inferior control rates were obtained with oral tongue lesions. For this subsite, the control rates for positive, close, and negative margins were 50%, 62% and 69% respectively. Conclusion: We conclude that excellent local control can be achieved with postoperative radiation therapy, despite the presence of inadequate margins of resection, when doses of ≫ 60 Gy are used. Future strategies must be directed at further improving these results in patients with oral tongue lesions. © 1992. |
| Keywords: | cancer survival; controlled study; cancer surgery; retrospective studies; major clinical study; cancer recurrence; squamous cell carcinoma; carcinoma, squamous cell; cancer radiotherapy; combined modality therapy; cancer staging; recurrence risk; follow-up studies; neoplasm recurrence, local; risk; cancer control; mouth neoplasms; mouth cancer; oropharyngeal neoplasms; pharynx cancer; middle age; postoperative radiation; positive margins; human; male; female; priority journal; article |
| Journal Title: | International Journal of Radiation Oncology, Biology, Physics |
| Volume: | 25 |
| Issue: | 1 |
| ISSN: | 0360-3016 |
| Publisher: | Elsevier Inc. |
| Date Published: | 1993-01-01 |
| Start Page: | 17 |
| End Page: | 21 |
| Language: | English |
| DOI: | 10.1016/0360-3016(93)90139-m |
| PUBMED: | 8416876 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 March 2019 -- Source: Scopus |
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