Carcinoma buccal mucosa treated with definitive hypofractionated accelerated radiotherapy: a retrospective analysis of treatment outcomes.

IF 1.7 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Singapore medical journal Pub Date : 2023-08-17 DOI:10.4103/singaporemedj.SMJ-2021-282

Geethu Babu, Rejnish Ravikumar, Malu Rafi, Zuzaki Sharafuddin, S Arun Shankar, Preethi Sara George, Cessal Thommachan Kainickal, Ramadas Kunnambath

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Abstract

Introduction: Oral cancer is a major public health concern in India. Both conventional and altered fractionation radiotherapy schedules have been used in curative treatment of oral cancer. This study aimed to retrospectively evaluate the clinical profile and treatment outcomes of patients with carcinoma buccal mucosa who underwent treatment with definitive hypofractionated accelerated radiotherapy.

Methods: A total of 517 patients treated from January 2011 to December 2016 were eligible for the analysis. All patients were treated with definitive hypofractionated accelerated radiotherapy schedule of 5,250 cGy in 15 fractions over 3 weeks. Survival estimates were generated using the Kaplan-Meier method.

Results: At a median follow-up of 77.4 months, 473 (91.5%) patients attained complete remission with radiation therapy. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 69% and 80.5%, respectively. The 5-year OS for stage I, II, III and IVa tumours was 80.3%, 84.4%, 81.4% and 73.7%, respectively, and the DFS was 75.7%, 73.2%, 69.6% and 60.2%, respectively. Age >50 years was found to be a significant factor affecting DFS (P = 0.026) and OS (P = 0.048) in multivariate analysis. Fifty-three (10.3%) patients developed osteoradionecrosis of the mandible.

Conclusion: Excellent outcome could be achieved in less-aggressive, low-volume carcinoma of the buccal mucosa with radical accelerated hypofractionated radiotherapy. A radiotherapy schedule over a 3-week period is useful in high-volume centres.

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明确低分割加速放疗治疗颊粘膜癌:治疗结果的回顾性分析。

口腔癌是印度一个主要的公共卫生问题。口腔癌的根治性治疗采用了常规和改变分割放疗方案。本研究旨在回顾性评估接受明确低分割加速放疗的颊粘膜癌患者的临床资料和治疗结果。方法:2011年1月至2016年12月共517例患者纳入分析。所有患者均在3周内接受5250 cGy的15次低分割加速放疗方案。生存估计使用Kaplan-Meier法生成。结果:在中位77.4个月的随访中，473例(91.5%)患者通过放射治疗获得完全缓解。5年无病生存率(DFS)和总生存率(OS)分别为69%和80.5%。I期、II期、III期和IVa期肿瘤5年OS分别为80.3%、84.4%、81.4%和73.7%，DFS分别为75.7%、73.2%、69.6%和60.2%。多因素分析发现年龄>50岁是影响DFS (P = 0.026)和OS (P = 0.048)的显著因素。53例(10.3%)患者发生下颌骨放射性骨坏死。结论:采用根治性加速低分割放疗治疗侵袭性较低、体积较小的颊粘膜癌可取得较好的疗效。放疗计划超过3周期间是有用的在高容量中心。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Singapore medical journal MEDICINE, GENERAL & INTERNAL-

CiteScore

3.40

自引率

3.70%

发文量

149

审稿时长

3-6 weeks

期刊介绍： The Singapore Medical Journal (SMJ) is the monthly publication of Singapore Medical Association (SMA). The Journal aims to advance medical practice and clinical research by publishing high-quality articles that add to the clinical knowledge of physicians in Singapore and worldwide. SMJ is a general medical journal that focuses on all aspects of human health. The Journal publishes commissioned reviews, commentaries and editorials, original research, a small number of outstanding case reports, continuing medical education articles (ECG Series, Clinics in Diagnostic Imaging, Pictorial Essays, Practice Integration & Life-long Learning [PILL] Series), and short communications in the form of letters to the editor.