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Improved outcomes in buccal squamous cell carcinoma.
Chun-Shu Lin1, Yee-Min Jen, Woei-Yau Kao
1Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. chunshulin@gmail.com
Head & Neck
|January 24, 2012
Summary
Buccal cancer survival significantly improved after 2002, coinciding with the introduction of intensity-modulated radiotherapy (IMRT). Treatment strategies were refined, recommending specific neck irradiation based on disease stage for better outcomes.
Area of Science:
- Oncology
- Head and Neck Surgery
- Radiation Oncology
Background:
- Buccal squamous cell carcinoma (SCC) treatment outcomes before and after 2002 were analyzed.
- A significant shift in treatment protocols occurred around 2002.
Purpose of the Study:
- To compare the efficacy of buccal cancer treatments administered before and after 2002.
- To identify factors influencing survival and locoregional control in buccal SCC.
- To establish evidence-based guidelines for neck irradiation in buccal cancer management.
Main Methods:
- Retrospective review of 245 patients with buccal cancer undergoing curative treatment.
- Multivariate analysis to assess the impact of clinical and pathological factors on survival.
- Comparison of treatment outcomes between early and late treatment periods.
Main Results:
- Five-year overall survival increased from 30.0% before 2002 to 53.5% after 2002 (p = .004).
- T classification, surgical margins, and treatment modality were significant predictors of survival.
- N classification and histologic grade showed trends affecting survival; invasion depth trended towards influencing locoregional control.
- For early-stage disease without adverse factors, surgery alone and surgery plus radiotherapy yielded similar locoregional control.
Conclusions:
- Survival rates for buccal cancer have improved post-2002, linked to the adoption of intensity-modulated radiotherapy (IMRT).
- Ipsilateral neck irradiation is recommended for T1-2N0-1 and small T3N0 buccal SCC.
- Bilateral neck irradiation should be reserved for advanced disease stages.
