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The Spatial Pattern of Recurrence in Oral Cavity Cancer Treated With Definitive (chemo)radiotherapy: A Tertiary
1Department of Clinical Oncology, Mount Vernon Cancer Centre, Greater London, United Kingdom.
Clinical Oncology (Royal College of Radiologists (Great Britain))
|April 16, 2026
Summary
Definitive intensity-modulated radiotherapy (IMRT) showed poor disease control for oral cavity squamous cell cancer (OCSCC). Careful treatment selection and delivery are crucial for improving outcomes with IMRT in OCSCC patients.
Area of Science:
- Radiation Oncology
- Medical Physics
- Head and Neck Cancer Research
Background:
- Oral cavity squamous cell carcinoma (OCSCC) presents a significant challenge in head and neck oncology.
- Intensity-modulated radiotherapy (IMRT) is a common treatment modality for OCSCC.
- Understanding recurrence patterns and dosimetric failures is crucial for optimizing IMRT in OCSCC.
Purpose of the Study:
- To evaluate the outcomes of OCSCC patients treated with definitive IMRT.
- To analyze the spatial and dosimetric characteristics of locoregional recurrences following IMRT for OCSCC.
- To identify factors influencing treatment success and failure patterns.
Main Methods:
- Retrospective analysis of OCSCC patients treated with definitive IMRT (2018-2021).
- Assessment of locoregional and overall survival (OS).
- Deformable coregistration of recurrence scans with planning CT to map recurrent gross tumor volumes (rGTVs) and analyze delivered dosimetry.
Main Results:
- Of 40 patients, 53% experienced locoregional recurrences, predominantly within 6 months post-IMRT.
- Recurrences were often central (Type A, 71%) and associated with a significant reduction in the delivered high-dose volume.
- Three-year OS was 36% for Stage IVa and 1-year OS was 22% for Stage IVb OCSCC patients.
Conclusions:
- Definitive IMRT alone did not achieve satisfactory disease control in the studied OCSCC patient cohort.
- Spatial and dosimetric analysis revealed significant deviations from planned dose delivery within recurrent tumor volumes.
- Improved patient selection and meticulous treatment delivery are essential for considering definitive IMRT as a curative option for OCSCC.
Keywords:
Accumulated dosimetryOral cavity cancerdeformable image registrationnonsurgical oral cavity cancer treatmentpattern of recurrencespatial dosimetryMore Related Videos
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