Oncologic outcome with versus without target volume compartmentalization in postoperative radiotherapy for oral cavity squamous cell carcinoma.

Autor:	Riggenbach E; Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Waser M; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Mueller SA; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.; Department of Otorhinolaryngology Head and Neck Surgery, University Hospital and University of Zurich, Zurich, Switzerland., Aebersold DM; Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Giger R; Department of Otorhinolaryngology, Head and Neck Surgery, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland., Elicin O; Department of Radiation Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Jazyk:	angličtina
Zdroj:	Frontiers in oncology [Front Oncol] 2024 Mar 25; Vol. 14, pp. 1362025. Date of Electronic Publication: 2024 Mar 25 (Print Publication: 2024).
DOI:	10.3389/fonc.2024.1362025
Abstrakt:	Background and Purpose: The volume treated with postoperative radiation therapy (PORT) in patients with oral cavity squamous cell carcinoma (OCSCC) is a mediator of toxicity affecting quality of life. Current guidelines only allow for very limited reduction of PORT volumes. This study investigated the safety and efficacy of de-intensified PORT for patients with OCSCC by refined compartmentalization of the treatment volume. Materials and Methods: This retrospective cohort study identified 103 OCSCC patients treated surgically from 2014 to 2019 with a loco-regional risk profile qualifying for PORT according to guidelines. PORT was administered only to the at-risk compartment and according to a refined compartmentalization concept (CC). Oncological outcome of this CC cohort was compared to a historical cohort (HC) of 98 patients treated before the CC was implemented. Results: Median follow-up time was 4.5 and 4.8 years in the CC and HC cohorts, respectively. In the CC cohort, a total of 72 of 103 patients (70%) had a pathological risk profile that allowed for further compartmentalization and, hence, received a reduced treatment volume or omission of PORT altogether. Loco-regional control at 3 and 5 years was 77% and 73% in the CC cohort versus 78% and 73% in the HC ( p = 0.93), progression-free survival was 72% and 64% versus75% and 68% ( p = 0.58), respectively. Similarly, no statistically significant difference was seen in other outcome measures. Conclusions: De-intensified PORT limiting the treatment volume to the at-risk compartment or avoiding PORT altogether for low-risk patients with OCSCC does not seem to compromise disease control in this retrospective comparison. Based on these hypothesis-generating findings, a prospective study is being planned. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Riggenbach, Waser, Mueller, Aebersold, Giger and Elicin.)
Databáze:	MEDLINE
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