The meeting on oral oncology was recently held in Singapore. Of the many papers presented there, a couple were of particular interest. The 3rd congress of the International Academy of Oral Oncology was held on July 14—17, 2011, in Singapore.

Predicting long term survival in base of tongue cancers

The treatment of squamous-cell carcinoma of the tongue-base has evolved from surgery and radiotherapy towards concomitant chemoradiation. Richard Nason (Manitoba, Canada) and colleagues presented results from a historical cohort of 290 patients with advanced cancer of the base of the tongue—followed prospectively—to assess 10-year treatment outcomes over the time that the pattern of treatment was changing. Multivariate models showed an independent effect of stage, sex, age, and initial treatment modality on overall survival. Treatment with radiotherapy and chemotherapy reduced the risk of death over 10 years by 89% (HR 0·11, 95%CI 0·1—0·2; p<0·0001) and surgery plus radiotherapy reduced the risk of death over 10 years by 87% (HR 0·13, 95%CI 0·1—0·2, p<0·0001).

Lymph node metastasis gene expressions

The assessment and treatment of regional lymph nodes in the neck of patients with squamous-cell carcinoma of the head and neck is the subject of much debate. Frank Leusink (Utrecht, Netherlands) and colleagues presented the validation study of a lymph-node-metastasis gene expression signature to discriminate metastasising from non-metastasising disease. Gene expression was analysed using a DNA microarray that included 696 previously reported predictive genes. The negative predictive value of the signature was assessed on the whole multicentre cohort (n=222), on clinically node negative (cN0) tumours (n=143), and on T1 and T2,cN0 oral cavity squamous-cell carcinoma samples (n=101). The negative predictive value of the gene signature was 72% overall, 85% for the cN0 subset, and 89% for the T1 and T2,cN0 group.

Palliative radiotherapy

Sushmita Ghoshal (Chandigarh, India) and colleagues presented results of a prospective study comparing the palliation achieved with a 2-day so-called Quad shot radiotherapy regimen to a standard 2-week treatment. 50 patients with stage IV head and neck cancer were randomly assigned to receive either Quad shot palliation treatment (14 Gy in four fractions over 2 days) or standard palliation (30 Gy in ten fractions over 2 weeks). Quality of life (QOL) before and after treatment was assessed using the Washington University questionnaire. Pain relief, swelling, dysphagia, and hoarseness was 62%, 86%, 40%, and 63% for the Quad shot group versus 77%, 91%, 50%, and 54% for standard palliation, respectively. QOL improved in both arms with no statistical difference. With median overall survival of 5 months for the patients receiving Quad shot palliation versus 6 months for those receiving standard treatment, the 2-day Quad shot treatment could be a suitable option for palliative radiotherapy in rural or remote areas.