Oral cavity cancers treated with superselective intra-arterial chemoradiotherapy with radiation doses less than 60 Gy: implications for dose reduction from a propensity score-matched analysis

Abstract

Background: The optimal radiation dose for oral cavity cancers treated with retrograde superselective intra-arterial chemoradiotherapy (SIACRT) is unclear. The aim of the present study was to evaluate the treatment outcome and toxicity in patients treated with <60 Gy compared with those treated with ≥60 Gy to provide evidence for determining the optimal dose. Materials and Methods: Between January 2009 and December 2013, 159 oral cavity cancer patients were treated with SIACRT with curative intent at a single institution. One hundred and twenty-nine patients received ≥60 Gy and 30 received <60 Gy. Local control (LC), disease-free survival (DFS), overall survival (OS), and toxicity were compared. Propensity score matching was performed to reduce bias. Results: The median follow-up period was 48 months (range, 2–88 months). LC (<60 Gy vs. ≥60 Gy, 81.5% vs. 86.1% at 3 years, p = 0.534), DFS (68.8% vs. 72.4% at 3 years, p = 0.816), and OS (85.9% vs. 72.3% at 3 years, p = 0.132) were comparable between the two groups. There was also no difference in toxicity. However, the median overall treatment period was significantly shorter in the <60 Gy cohort (39 days vs. 49 days, p < 0.0001). Conclusion: The radiation dose may be reduced to <60 Gy when treating oral cavity cancers with SIACRT.