Tumor control and survival after postoperative radiotherapy for high-risk oral cavity cancer: A retrospective cohort study

Background: We evaluated locoregional failure (LRF) and survival after postoperative radiotherapy (PORT) in selected high-risk oral squamous cell carcinoma (OSCC) patients. Methods: In a retrospective OSCC cohort (n = 219) treated with local (n = 216) and/or regional (n = 87) PORT in 2011–2018, we d...

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Main Authors: Pepijn B Bolleurs, Brend P Jonker, Joris BW Elbers, Gerda M Verduijn, Atilla Gül, Aniel Sewnaik, Wilma D Heemsbergen
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Clinical and Translational Radiation Oncology
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Online Access:http://www.sciencedirect.com/science/article/pii/S2405630825000801
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author Pepijn B Bolleurs
Brend P Jonker
Joris BW Elbers
Gerda M Verduijn
Atilla Gül
Aniel Sewnaik
Wilma D Heemsbergen
author_facet Pepijn B Bolleurs
Brend P Jonker
Joris BW Elbers
Gerda M Verduijn
Atilla Gül
Aniel Sewnaik
Wilma D Heemsbergen
author_sort Pepijn B Bolleurs
collection DOAJ
description Background: We evaluated locoregional failure (LRF) and survival after postoperative radiotherapy (PORT) in selected high-risk oral squamous cell carcinoma (OSCC) patients. Methods: In a retrospective OSCC cohort (n = 219) treated with local (n = 216) and/or regional (n = 87) PORT in 2011–2018, we determined the first location of tumor recurrence or progression, survival, and cause of death. Tumor control and survival was calculated using Kaplan Meier method. Prognostic factors were evaluated in Cox regression models. Results: Main subsites were oral tongue (34 %), gingiva (32 %), and floor of mouth (27 %). Eight percent also received chemotherapy. Median follow-up was five year for tumor control and eight year for survival. Tumor progression was observed in 47 patients (n = 31 LRF). Nine patients had salvage treatment. Locoregional control was 87 % and 84 % at 2 and 5 years, respectively. Significant prognostic factors for local failure (LF) were T4 stage, bone invasion, and subsite gingiva; 12 of 18 LF concerned a T4 gingiva tumor with bone invasion. For regional failure (RF), pN1 (vs pN0) was prognostic, mainly concerning solitary contralateral RFs. Overall survival was 63 % and 48 % at 5 and 8 year, respectively. Main causes of death (104 events) were the index tumor (n = 42) and a post-treatment second primary tumor (n = 37). Conclusion: A locoregional control of 84 % was achieved after PORT for high-risk OSCC with only 8 % receiving additional chemotherapy. Overall survival was 48 % at 8 years, with a large proportion of cancer-related deaths related to the index tumor and other subsequent tumor diagnoses. Risk of LF was increased for gingiva tumors with bone invasion. N1 stage was associated with a risk of solitary contralateral RFs in non-irradiated neck areas.
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spelling doaj-art-0fa57aa5af5343d49f546fb34ddba2b32025-08-20T03:22:00ZengElsevierClinical and Translational Radiation Oncology2405-63082025-07-015310098810.1016/j.ctro.2025.100988Tumor control and survival after postoperative radiotherapy for high-risk oral cavity cancer: A retrospective cohort studyPepijn B Bolleurs0Brend P Jonker1Joris BW Elbers2Gerda M Verduijn3Atilla Gül4Aniel Sewnaik5Wilma D Heemsbergen6Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands; Erasmus University College, Rotterdam, the NetherlandsDepartment of Oral and Maxillofacial Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Oral and Maxillofacial Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands; Department of Oral and Maxillofacial Surgery and Head and Neck Surgery, Elisabeth-TweeSteden Hospital, Tilburg, the NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the NetherlandsDepartment of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands; Corresponding author at: Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.Background: We evaluated locoregional failure (LRF) and survival after postoperative radiotherapy (PORT) in selected high-risk oral squamous cell carcinoma (OSCC) patients. Methods: In a retrospective OSCC cohort (n = 219) treated with local (n = 216) and/or regional (n = 87) PORT in 2011–2018, we determined the first location of tumor recurrence or progression, survival, and cause of death. Tumor control and survival was calculated using Kaplan Meier method. Prognostic factors were evaluated in Cox regression models. Results: Main subsites were oral tongue (34 %), gingiva (32 %), and floor of mouth (27 %). Eight percent also received chemotherapy. Median follow-up was five year for tumor control and eight year for survival. Tumor progression was observed in 47 patients (n = 31 LRF). Nine patients had salvage treatment. Locoregional control was 87 % and 84 % at 2 and 5 years, respectively. Significant prognostic factors for local failure (LF) were T4 stage, bone invasion, and subsite gingiva; 12 of 18 LF concerned a T4 gingiva tumor with bone invasion. For regional failure (RF), pN1 (vs pN0) was prognostic, mainly concerning solitary contralateral RFs. Overall survival was 63 % and 48 % at 5 and 8 year, respectively. Main causes of death (104 events) were the index tumor (n = 42) and a post-treatment second primary tumor (n = 37). Conclusion: A locoregional control of 84 % was achieved after PORT for high-risk OSCC with only 8 % receiving additional chemotherapy. Overall survival was 48 % at 8 years, with a large proportion of cancer-related deaths related to the index tumor and other subsequent tumor diagnoses. Risk of LF was increased for gingiva tumors with bone invasion. N1 stage was associated with a risk of solitary contralateral RFs in non-irradiated neck areas.http://www.sciencedirect.com/science/article/pii/S2405630825000801Oral squamous cell carcinomaPostoperative radiotherapyLocoregional controlSurvival
spellingShingle Pepijn B Bolleurs
Brend P Jonker
Joris BW Elbers
Gerda M Verduijn
Atilla Gül
Aniel Sewnaik
Wilma D Heemsbergen
Tumor control and survival after postoperative radiotherapy for high-risk oral cavity cancer: A retrospective cohort study
Clinical and Translational Radiation Oncology
Oral squamous cell carcinoma
Postoperative radiotherapy
Locoregional control
Survival
title Tumor control and survival after postoperative radiotherapy for high-risk oral cavity cancer: A retrospective cohort study
title_full Tumor control and survival after postoperative radiotherapy for high-risk oral cavity cancer: A retrospective cohort study
title_fullStr Tumor control and survival after postoperative radiotherapy for high-risk oral cavity cancer: A retrospective cohort study
title_full_unstemmed Tumor control and survival after postoperative radiotherapy for high-risk oral cavity cancer: A retrospective cohort study
title_short Tumor control and survival after postoperative radiotherapy for high-risk oral cavity cancer: A retrospective cohort study
title_sort tumor control and survival after postoperative radiotherapy for high risk oral cavity cancer a retrospective cohort study
topic Oral squamous cell carcinoma
Postoperative radiotherapy
Locoregional control
Survival
url http://www.sciencedirect.com/science/article/pii/S2405630825000801
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