locoregional control

Prognostic factors linked with poor locoregional control in tongue cancer

Source: www.cancernetwork.com Author: Gina Mauro Depth of invasion, lymphovascular space invasion, and positive glossectomy specimen margins were all found to be linked with inferior locoregional control (LRC) in patients with pT1-2N0 oral tongue squamous cell carcinoma who were treated with partial glossectomy and elective neck dissection alone. The retrospective findings, which were presented during the 2024 ASTRO Multidisciplinary Head and Neck Cancers Symposium, were seen even with final negative tumor bed margins. Results showed that, at a median follow-up of 45.6 months, the 3-year LRC and overall survival (OS) rates were 88.0% and 92.5%, respectively, in the all-comer patient population. In patients with pT1 disease, these rates were 92.0% and 95.2%, respectively; they were 85.0% and 90.5% in those with pT2 disease. However, upon the multivariate analysis, those with positive glossectomy margins had worse LRC (HR, 6.66; 95% CI, 1.60-27.78; P = .009). Lymphovascular space invasion (HR, 6.90; 95% CI, 1.42-33.65; P = .02) and depth of invasion (HR, 1.31; 95% CI, 1.06-1.63; P = .01) were also associated with inferior LRC. “Patients with these risk factors may be considered for adjuvant radiotherapy to optimize disease control,” lead study author Michael Modzelewski, MD, of Kaiser Permanente Bernard J. Tyson School of Medicine, in Pasadena, California, and coinvestigators wrote in a poster presented at the meeting. Patients who have early-stage tongue squamous cell carcinoma do not typically receive adjuvant radiation because they are often at low risk for recurrence. Following surgery, the status of main glossectomy specimen margin has been shown [...]

Oral Cancer Foundation News Team - A2024-03-06T20:42:18-07:00March, 2024|Oral Cancer News|

Radiation planning reduces dysphagia in oropharyngeal cancer

Source: www.medscape.com Author: Nick Mulcahy In patients with oropharyngeal cancer, modifying radiotherapy to spare swallowing structures appears to be an effective strategy to reduce the long-term dysphagia that accompanies chemoradiotherapy, according to a small longitudinal study. Importantly, the strategy did not come at the expense of locoregional control, report investigators in a study published online April 26 in the Journal of Clinical Oncology. Dysphagia has emerged as perhaps the most important late adverse effect in this setting, supplanting xerostomia, said the study's senior author, Avraham Eisbruch, MD, professor of radiation oncology at the University of Michigan Medical School and Comprehensive Cancer Center in Ann Arbor. "Aggressive chemoradiotherapy approaches produce more dysphagia than in the past," he told Medscape Oncology. Meanwhile, the late adverse effect of xerostomia is on the wane, because the use of intensity-modulated radiotherapy (IMRT) has allowed radiation oncologists to spare most patients' salivary glands from radiation, he said. To address the problem of dysphagia, Dr. Eisbruch and colleagues at the University of Michigan used IMRT in combination with chemotherapy. Their treatment planning for 73 patients with stages III to IV oropharyngeal cancer included sparing any swallowing structure that did not have tumor involvement. The structures included pharyngeal constrictors, glottic and supraglottic larynx, and esophagus. One year after concurrent chemotherapy and IMRT, all 73 of the patients had either absent or minimal observer-rated dysphagia (scores, 0 to 1), with the exception of 4 people: 1 who was feeding-tube dependent and 3 who required a soft diet. The results [...]

Oral Cancer Foundation News Team - A2010-05-19T20:47:25-07:00May, 2010|Oral Cancer News|

Prolonged treatment delay did not affect outcomes in SCCHN

Source: www.hemonctoday.com Author: Christen Haigh No association was found between diagnosis to treatment interval and tumor control outcomes in patients with squamous cell carcinoma of the head and neck (SCCHN). However, patients with poor Karnofsky performance status, black patients and patients treated with intensity-modulated radiation therapy all had prolonged diagnosis to treatment interval. Jimmy J. Caudell Jr., MD, PhD, assistant professor of radiation oncology at the University of Mississippi, Jackson, presented the findings at the Multidisciplinary Head & Neck Cancer Symposium in Chandler, Ariz. Prolonged treatment delay from the time of diagnosis may often occur in patients with locoregionally advanced head and neck cancer due to social, dental, nutritional and radiotherapy planning procedures that need to be resolved prior to treatment initiation, according to researchers. To assess factors affecting treatment delay, researchers analyzed data from 426 patients with SCCHN treated with radiotherapy from 1995 to 2007 at the University of Alabama-Birmingham. The median follow-up was 42 months. The median diagnosis to treatment interval was 34 days. Longer than median diagnosis to treatment interval was associated with treatment off protocol (P=.002), black ethnicity (P=.005), insurance type (P

Oral Cancer Foundation News Team - A2010-03-05T07:32:43-07:00March, 2010|Oral Cancer News|

Ipsilateral radiation controls tonsil cancer

Source: www.medpagetoday.com Author: Charles Bankhead, Staff Writer, MedPage Today Patients with newly diagnosed tonsillar cancer can have long-term disease control and minimal risk of contralateral recurrence with ipsilateral (same side) radiation therapy, data from a large patient series showed. Only two of 102 patients had contralateral failure during a treatment experience dating back to 1970. Ipsilateral radiation therapy resulted in 100% locoregional control at the primary site and ipsilateral neck. "In properly selected patients, ipsilateral radiotherapy to the involved primary site and neck provides excellent local control with a low risk of contralateral nodal failure," Gregory Chronowski, MD, of M.D. Anderson Cancer Center in Houston, reported at the Multidisciplinary Head and Neck Cancer Symposium. "High neck, nonbulky, N2b neck disease does not appear to be a contraindication to ipsilateral radiotherapy in patients with T1-T2 primary tumors. Neck dissection appears to offer reasonable salvage therapy in the event of isolated contralateral neck failure." Limiting radiation therapy to the ipsilateral primary site and neck offers potential advantages over more extensive irradiation. Limiting the treated area minimizes the risk of xerostomia and avoids complications related to exposure of the uninvolved contralateral vasculature, dentition, and musculature. A retrospective review of a large case series from Toronto provided the first evidence that a limited approach to radiation therapy offers good local control and minimal risk of contralateral failure (Int J Radiat Oncol Biol Phys 2001; 51: 332-43). That analysis showed a three-year local control rate of 77%, cause-specific survival of 76%, and contralateral failure rate [...]

Oral Cancer Foundation News Team - A2010-03-01T19:21:16-07:00March, 2010|Oral Cancer News|

Impact of tumor board recommendations on treatment outcome for locally advanced head and neck cancer

Source: Oncology, October 8, 2008; 75(3-4): 186-191 Author: Nam P Nguyen et al. Background/Aims: To identify physician selection factors in the treatment of locally advanced head and neck cancer and how treatment outcome is affected by Tumor Board recommendations. Methods: A retrospective analysis of 213 patients treated for locally advanced head and neck cancer in a single institution was performed. All treatments followed Tumor Board recommendations: 115 patients had chemotherapy and radiation, and 98 patients received postoperative radiation. Patient characteristics, treatment toxicity, locoregional control and survival between these two treatment groups were compared. Patient survival was compared with survival data reported in randomized studies of locally advanced head and neck cancer. Results: There were no differences in comorbidity factors, and T or N stages between the two groups. A statistically significant number of patients with oropharyngeal and oral cavity tumors had chemoradiation and postoperative radiation, respectively (p

Oral Cancer Foundation News Team - A2008-10-12T17:35:20-07:00October, 2008|Oral Cancer News|