Clinical oncology最新文献

{"title":"The National Referral Service for Proton Beam Therapy in England: A Journey Towards Equitable Access","authors":"S. Gaito ,&nbsp;A. France ,&nbsp;Y. Wang ,&nbsp;M. Aznar ,&nbsp;N. Burnet ,&nbsp;A. Crellin ,&nbsp;J. Kennedy ,&nbsp;P. Sitch ,&nbsp;E. Smith ,&nbsp;G. Whitfield","doi":"10.1016/j.clon.2025.103868","DOIUrl":"10.1016/j.clon.2025.103868","url":null,"abstract":"<div><h3>Aim</h3><div>Health care policies have frequently centred on ensuring equitable access within diverse populations. While new technologies have immense potential for improving health outcomes, they may not be necessarily available across varied geographical areas and socioeconomic backgrounds. The goal of this study is to analyse equity of access to Proton Beam Therapy (PBT) throughout England and how this has changed since the inception of a national PBT service in 2018.</div></div><div><h3>Materials and methods</h3><div>The Proton Utilisation Proportion (PUP) is the ratio between treated and newly diagnosed patients, which measures the proportion of eligible patients using the technology. These figures were provided for 7 of the most prevalent PBT cancer indications for the period 2013-2019. The first national NHS PBT centre began accepting referrals in October 2018, hence this time period was divided into pre-NHS PBT and post-NHS PBT.</div></div><div><h3>Results</h3><div>For the seven most common PBT cancer indications, the total number of newly diagnosed patients was 1686 before NHS PBT and 381 after NHS PBT. The number of treated patients was 479 in the pre-NHS PBT era and 180 afterwards. Overall, the PUP in England grew post-NHS PBT by 66%. More specifically, there is an increase in the PUP between the pre-NHS and post-NHS PBT for any diagnostic category and age group analysed. Among the diagnostic categories analysed, the greatest increase is seen in Medulloblastoma, which became a commissioned indication for PBT in 2016. By age group, post-NHS PBT the most noticeable increase is seen for the age group 16-24.</div></div><div><h3>Conclusion</h3><div>Promoting equal access to cutting-edge radiation technology is central to NHS England's core values. The PUP has expanded since the establishment of a National PBT service in England, which employs a central web-based Proton Referral Pathway overseen by a National Proton Office. Further investigation will be conducted to determine whether socioeconomic or geographic barriers exist between different areas.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103868"},"PeriodicalIF":3.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144262727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and Outcomes of Craniospinal Irradiation and Concurrent Daily Carboplatin in Children and Adults With High-risk Central Nervous System Tumours","authors":"R. Singer ,&nbsp;C. Lorimer ,&nbsp;L. Welsh ,&nbsp;F. Carceller ,&nbsp;S. Vaidya ,&nbsp;L.V. Marshall ,&nbsp;J. Stone ,&nbsp;R. Evans ,&nbsp;B. O'Leary ,&nbsp;S. Zacharoulis ,&nbsp;F. Saran ,&nbsp;H. Mandeville","doi":"10.1016/j.clon.2025.103866","DOIUrl":"10.1016/j.clon.2025.103866","url":null,"abstract":"<div><h3>Aims</h3><div>High-risk medulloblastoma, pineoblastoma, and other embryonal central nervous system (CNS) tumours are associated with a poor prognosis. Children's Oncology Group trial CCG-99701 demonstrated concomitant daily carboplatin during radiotherapy, followed by adjuvant chemotherapy, to be a promising strategy for treating these malignancies in children. In this case series, we describe treatment feasibility, toxicities, and outcomes for children and adults from a heterogeneous real-world population, treated with this regimen for high-risk CNS tumours.</div></div><div><h3>Materials and methods</h3><div>Data from clinical records were collected on surgery, radiotherapy, chemotherapy, acute toxicities, supportive treatment, and survival for all patients treated with the regimen between January 2012 and June 2018.</div></div><div><h3>Results</h3><div>Twenty-seven patients (13 children and 14 adults) received chemoradiotherapy. Seven patients (26%) were rested for one or more radiotherapy fractions due to medical or anaesthetic issues, and 4 patients (15%) had an extended overall treatment time. Grade 4 haematological toxicity was common, but no grade 4 non-haematological toxicities were observed. Twenty-two patients (81%) required haematological support. Two patients discontinued adjuvant chemotherapy early due to toxicity. Two-year overall survival (OS) in paediatric and adult patients was 85% and 46%, respectively, and 5-year OS was 69% and 38%, respectively. Progression-free survival (PFS) was significantly longer in paediatric patients than in adults (median PFS not reached and 0.9 years, respectively; hazard ratio: 0.26; 95% confidence interval [CI]: 0.09 to 0.75; <em>P</em> = 0.01). There was no significant difference in OS between paediatric and adult patients (median OS not reached and 1.3 years, respectively; hazard ratio: 0.43; 95% CI: 0.14 to 1.29; <em>P</em> = 0.12).</div></div><div><h3>Conclusion</h3><div>The treatment regimen was feasible for paediatric and adult patients but was associated with significant toxicity. The survival outcomes in paediatric patients were favourable, consistent with published data. Due to the close clinical supervision required, this regimen should ideally be delivered in centres with experience in managing paediatric or teenage and young adult high-risk CNS tumours.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103866"},"PeriodicalIF":3.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advanced Epithelial Ovarian Cancer: Have We Really Improved Care for Patients Aged 70 Years and Older? A 20-year Registry-based Study","authors":"J. Barben ,&nbsp;A. Mamguem Kamga ,&nbsp;V. Quipourt ,&nbsp;S. Marilier ,&nbsp;J. Niogret ,&nbsp;L. Bengrine-Lefevre ,&nbsp;T.S. Dabakuyo-Yonli","doi":"10.1016/j.clon.2025.103860","DOIUrl":"10.1016/j.clon.2025.103860","url":null,"abstract":"<div><h3>Aims</h3><div>Advanced epithelial ovarian cancer (aEOC, International Federation of Gynecology and Obstetrics(FIGO) stages IIIC-IV) is the most frequently diagnosed and lethal form of ovarian cancer. The aim of this study was to evaluate net survival (NS) over time and the differences between younger (&lt;70 years) and older (≥70 years) patients (OPs).</div></div><div><h3>Materials and Methods</h3><div>All patients with aEOC diagnosed in the French department of Côte d'Or between 01 January 1998 and 31 December 2018 were included. Two-year and 5-year NS were calculated for the two age groups over three periods: 1998 to 2004 (T1), 2005 to 2011 (T2), and 2012 to 2018 (T3).</div></div><div><h3>Results</h3><div>A total of 392 patients were included, of whom 154 (39.3%) were aged ≥70 years. Surgery-based treatment was used less frequently in OPs (58.15% vs 83.41%, <em>P</em> &lt; 0.0001) and decreased over time, notably in OPs (74.2% at T1 vs 34.8% at T3, <em>P</em> &lt; 0.001). There was a clear increase in chemotherapy alone at T3 vs T1 in OPs (odds ratio = 8.14, 95% confidence interval [CI]: [2.49-26.58], <em>P</em> &lt; 0.001). The 5-year NS was lower in OPs (23.3%, 95% CI: [17.1-31.8] vs 44.6%, 95% CI: [38.7%-51.6%], <em>P</em> &lt; 0.001) over the 20-year period. The only significant difference in NS between patients aged ≥70 years and &lt;70 years was observed during T3, 17.9% (95% CI: [10.9-29.5]) vs 42.9% (95% CI: [33.8-54.4], <em>P</em> &lt; 0.001) for 5-year NS.</div></div><div><h3>Conclusion</h3><div>NS for aEOC was lower in women aged ≥70 years, especially from 2012 to 2018. Nonoptimal treatment was also more frequent in the older age group.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"43 ","pages":"Article 103860"},"PeriodicalIF":3.2,"publicationDate":"2025-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of Radiotherapy Activity in Scotland, 2 Years Post COVID","authors":"L. Grocutt ,&nbsp;T. Rowe ,&nbsp;D. Caldwell ,&nbsp;A.J. Chalmers ,&nbsp;A. Rutherford ,&nbsp;C. Wilkinson ,&nbsp;S.M. O'Cathail","doi":"10.1016/j.clon.2025.103862","DOIUrl":"10.1016/j.clon.2025.103862","url":null,"abstract":"<div><h3>Aims</h3><div>Now that the world has returned to normal following the COVID-19 pandemic, there are concerns that the pandemic has had a negative, ongoing effect on cancer care. This study aims to investigate the impact of the COVID-19 pandemic on radiotherapy services in Scotland.</div></div><div><h3>Materials and methods</h3><div>Detailed quantitative data of radiotherapy activity at our centre were collected from 01/04/2021–31/03/2023, which cover the second and third ‘post-COVID’ years. Differences in total/mean weekly radiotherapy courses, dose and fractionation patterns, and treatment intent for all treatment sites were compared to data from the year before the COVID-19 pandemic and the first year of the COVID-19 pandemic (01/04/2019–31/03/2021).</div></div><div><h3>Results</h3><div>Compared with the first year of the COVID-19 pandemic, the total number of radiotherapy courses increased from 6240 to 7899 (+32%) and 8188 (+35%) for the second and third years, respectively. Average weekly radiotherapy courses (AWRC) delivered increased from 120 (standard deviation [sd ± 15) during the COVID-19 pandemic to 152 (sd±15) and 157 (sd±19) in the two following years. In the two years post the COVID-19 pandemic, the total number of radical treatments increased from 5470 to 5912 (8.1%) and the total number of palliative treatments decreased from 2429 to 2206 (-9%). During the COVID-19 pandemic, a significantly greater reduction in radiotherapy utilisation was observed for females (3750-3156; -16%) than for males (3090-2839; -8%). In contrast, the two years post the COVID-19 pandemic have seen a significant increase in the number of women, with the total number of patients increasing to 4813 and 4860 (65–69%), receiving radiotherapy compared to male patients, with the total number of patients 3086 and 3256 (9–15%), respectively.</div></div><div><h3>Conclusion</h3><div>The two years post COVID-19 pandemic have seen a significant increase in radiotherapy activity compared to the first year of the COVID-19 pandemic and the year prior. The largest recoveries in radiotherapy delivery post the COVID-19 pandemic were observed in breast, cervical, rectal, and prostate cancer. Contrarily, a decrease in radiotherapy delivery was observed in patients with lung cancer. The increase in radiotherapy activity can likely be attributed to COVID-related suspensions of diagnostic tests, surgeries, and cancer screenings being reinstated.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"44 ","pages":"Article 103862"},"PeriodicalIF":3.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dose Accumulation for Pelvic Stereotactic Ablative Radiotherapy Reirradiation","authors":"F. Slevin ,&nbsp;C. O'Hara ,&nbsp;J. Entwisle ,&nbsp;J. Lilley ,&nbsp;M. Nix ,&nbsp;C. Thompson ,&nbsp;M. Tyyger ,&nbsp;A.L. Appelt ,&nbsp;L.J. Murray","doi":"10.1016/j.clon.2025.103861","DOIUrl":"10.1016/j.clon.2025.103861","url":null,"abstract":"<div><h3>Aims</h3><div>Despite the increasing use of reirradiation, our understanding of appropriate normal tissue dose constraints remains limited. This is intrinsically tied to major uncertainties concerning evaluation of cumulative doses from multiple treatment courses. This study aimed to: i) retrospectively evaluate cumulative normal tissue doses in patients treated with pelvic stereotactic ablative radiotherapy (SABR) reirradiation, taking account of anatomical change and fraction size effects, and ii) produce preliminary data regarding safe cumulative normal tissue doses.</div></div><div><h3>Materials and methods</h3><div>Fifty-six patients treated with pelvic SABR reirradiation for locoregional recurrence after prior radical or (neo)adjuvant radiotherapy in the pelvis were included. Original-treatment computed tomography (CT) scans were deformably registered to the reirradiation CTs; and target volumes, organs at risk (OARs), and dose distributions were transferred from the original anatomy to the reirradiation scan. Original and reirradiation dose distributions were converted into equivalent dose in 2-Gy fractions (EQD2). Cumulative doses were calculated using deformable image registration (DIR)–based dose summation and/or summed maximum doses (D0.5 cc) for each OAR. Severe toxicity events up to 2 years post reirradiation were evaluated.</div></div><div><h3>Results</h3><div>Most patients had prostate cancer (85.7%) and were treated for pelvic nodal recurrence (75%) with a single target volume (91.1%) using a prescription dose of 30 Gy in 5 fractions (90.3%). The median time between original and reirradiation was 53 months (interquartile range [IQR]: 36-79). Based on DIR, cumulative doses in EQD2 of up to 82.8 Gy for the rectum, 110.2 Gy for the bladder, 69.8 Gy for the colon, 101.4 Gy for the sacral plexus, and 108.1 Gy for the vessels were observed. Based on summed D0.5 cc, cumulative doses of up to 111.9 Gy were delivered to the small bowel. No severe toxicity events which could be attributed to reirradiation were observed.</div></div><div><h3>Conclusions</h3><div>This study has demonstrated feasibility of per-voxel anatomically and radiobiologically appropriate 3-dimensional evaluation of cumulative normal tissue doses in patients previously treated with pelvic SABR reirradiation. No toxicity events could be attributed to the cumulative or reirradiation doses delivered.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"43 ","pages":"Article 103861"},"PeriodicalIF":3.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144147820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiation Therapy Combined With 5-Aminolevulinic Acid: Effect on Primary Human Meningioma Cells","authors":"S. Ebrahimi ,&nbsp;M. Rezaei Arjomand ,&nbsp;A. Tabibkhooei ,&nbsp;M. Khaleghi Ghadiri ,&nbsp;W. Stummer ,&nbsp;A. Gorji","doi":"10.1016/j.clon.2025.103863","DOIUrl":"10.1016/j.clon.2025.103863","url":null,"abstract":"<div><h3>Aims</h3><div>Radiation therapy (RT) is a standard treatment for certain meningiomas; however, it does not consistently achieve favorable favourable outcomes. Therefore, discovering new agents that can enhance the radiosensitivity of meningiomas is of considerable interest. Evidence suggests that 5-aminolevulinic acid (5-ALA) acts both as a photosensitiszer and a radiosensitiszer. This study aimed to evaluate the efficacy of combining 5-ALA with RT on primary meningioma cells, which were obtained from eight patients during surgery.</div></div><div><h3>Methods</h3><div>Primary meningioma cells were characterized by immunocytochemistry using specific markers. Cell proliferation following treatment with 5-ALA, with or without RT, was evaluated using the WST-1 assay. Accumulation of protoporphyrin IX was evaluated fluorometrically.</div></div><div><h3>Results</h3><div>Our in vitro investigations indicate that whilste 5-ALA alone reduced cell proliferation, the combination of 5-ALA and RT resulted in more pronounced cell growth inhibition. The cytotoxic doses of 5-ALA markedly varied amongst cells from different meningioma patients. Furthermore, the study revealed that 5-ALA effectively induced the accumulation of protoporphyrin IX, a highly pro-apoptotic and fluorescent photosensitiszer, within the meningioma cells.</div></div><div><h3>Conclusion</h3><div>Our data suggest that 5-ALA significantly enhances the antitumor antitumour effects of RT, offering a new option for further exploration of 5-ALA combined with RT as a valuable strategy for meningioma treatment.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"43 ","pages":"Article 103863"},"PeriodicalIF":3.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144204098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising Axillary Lymph Node Delineation for Consistent Dosimetry in Breast Radiotherapy","authors":"Q. Xu","doi":"10.1016/j.clon.2025.103859","DOIUrl":"10.1016/j.clon.2025.103859","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"43 ","pages":"Article 103859"},"PeriodicalIF":3.2,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144134216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OncoFlash - Research Updates in a Flash! (June 2025)","authors":"C.W. Bleaney ,&nbsp;C. Crockett","doi":"10.1016/j.clon.2025.103858","DOIUrl":"10.1016/j.clon.2025.103858","url":null,"abstract":"","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"42 ","pages":"Article 103858"},"PeriodicalIF":3.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143903908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Employing Digital Health for the Follow-up and Monitoring of Patients Undergoing Anticancer Treatment: First Results of Satelia®Onco on Patient Satisfaction and Recommendations of Use in France","authors":"M. Zysman ,&nbsp;A. Creisson ,&nbsp;G. Ghrenassia ,&nbsp;S. Nisse-Durgeat ,&nbsp;A. Boyer ,&nbsp;M. Matranga ,&nbsp;C. Bedel ,&nbsp;N. Pages ,&nbsp;J. Ducray","doi":"10.1016/j.clon.2025.103856","DOIUrl":"10.1016/j.clon.2025.103856","url":null,"abstract":"<div><h3>Aims</h3><div>Telemedicine involves the use of information communication technologies and aims to support disease management, enhance treatment adherence, and improve patients’ quality of life (QoL). Despite its growing advantages, many challenges persist in its widespread adoption, which may be influenced by the health status and digital literacy of users. The objective of this study was to explore patient satisfaction with a web application used for the monitoring and follow-up of anticancer treatment.</div></div><div><h3><em>Material and methods</em></h3><div>A descriptive, multicentric, survey-based study was conducted with adult patients undergoing treatment in two oncology centres in France from October 2, 2023 to December 11, 2023. The online survey included 15 items covering the perceived usefulness, ease of use, and impact on QoL of a telemedicine solution used to monitor the side effects of anticancer treatment. Analysis was stratified by cancer type, duration of use, and age group.</div></div><div><h3><em>Results</em></h3><div>A total of 104 patients participated in the study (response rate: 33.0%). Most patients were female (64.4%), aged 46–65 years (42.3%), and were receiving treatment for lung cancer (50.0%) or breast cancer (39.4%). Remote monitoring was predominantly used for less than three months (39.4%), followed by more than six months (34.6%). Patient satisfaction and recommendation rates were high across age groups, cancer type, and durations of use (82.7%, respectively). Patients with breast cancer (82.9%) and lung cancer (82.7%) reported being absolutely satisfied. Positive feedback encompassed ease of access, comprehension of follow-up questions, and perceived usefulness. Older patients reported slightly lower scores for ease of use and improvement in QoL.</div></div><div><h3><em>Conclusion</em></h3><div>To our knowledge, these findings are among the first preliminary results concerning patient satisfaction for telemedicine use to monitor the side effects of anticancer treatment in clinical practice settings in France.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"43 ","pages":"Article 103856"},"PeriodicalIF":3.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Survival Outcomes and Recurrence Patterns in Oral Cavity Squamous Cell Carcinoma (OCSCC) Patients Treated With Curative Intent Either With Adjuvant or Definitive (Chemo)radiotherapy","authors":"K. Oguejiofor ,&nbsp;S. Ramkumar ,&nbsp;A.-A. Nabi ,&nbsp;K. Moutasim ,&nbsp;R.P. Singh ,&nbsp;S. Sharma ,&nbsp;M. Ethunandan ,&nbsp;I.S. Boon","doi":"10.1016/j.clon.2025.103855","DOIUrl":"10.1016/j.clon.2025.103855","url":null,"abstract":"<div><h3>Aims</h3><div>To assess the survival outcome and recurrence patterns of locally advanced oral cavity squamous cell carcinoma (LA-OCSCC) treated with radical surgery followed by adjuvant or definitive upfront (chemo)radiotherapy.</div></div><div><h3>Materials and methods</h3><div>This is a single United Kingdom cancer centre retrospective analysis on LA-OCSCC treated with curative intent. All OCSCC patients treated between 2012 and 2022 were included with groups treated with either postoperative adjuvant (chemo)-radiotherapy or definitive (chemo)radiotherapy. Patients who recurred before starting adjuvant treatments were excluded.</div></div><div><h3>Results</h3><div><em>Patient characteristics</em>: Ninety-nine (73.9%) patients were treated with primary surgery followed by adjuvant (chemo)radiotherapy and 35 (26.1%) patients treated in the definitive group, respectively. <em>Survival</em>: The median progression-free survival was 17 months and 15 months for adjuvant and definitive groups, respectively (<em>P</em> value of 0.947). Median overall survival was 61 months and 43 months for adjuvant and definitive groups, respectively (<em>P</em> value of 0.154). Smoking history is an independent negative predictor for survival. <em>Recurrence</em>: Median time to local and distant recurrence was 17 months and 15 months, respectively. In the adjuvant group, the local recurrence rate is 26% and the distant recurrence rate is 32%, compared with the definitive group at 26% and 34%, respectively. The rate of recurrence is highest in the first two years after diagnosis. Distant recurrence in LA-OCSCC can happen without prior local-regional recurrence.</div></div><div><h3>Conclusion</h3><div>Patients with surgically resectable LA-OCSCC patients treated with primary radical surgery followed by adjuvant (chemo)radiotherapy had better survival outcomes compared with patients treated with upfront definitive (chemo)radiotherapy. The pattern of recurrence of LA-OCSCC is aggressive and without curative surgery the rate of survival is poorer.</div></div>","PeriodicalId":10403,"journal":{"name":"Clinical oncology","volume":"43 ","pages":"Article 103855"},"PeriodicalIF":3.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144124155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}