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Postoperative Unilateral Neck Irradiation for Oral Cancer: Risk Factors for Contralateral Neck Recurrence and
Hiroaki Wakiyama1, Tadamasa Yoshitake1, Keiji Matsumoto1
1Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, JPN.
Cureus
|June 19, 2026
Summary
Unilateral neck irradiation shows promise for select oral cancer patients, reducing recurrence risk. Factors like fewer lymph nodes and lower T stage indicate better outcomes with this approach.
Area of Science:
- Oncology
- Radiation Oncology
- Head and Neck Surgery
Background:
- Postoperative irradiation is standard for high-risk oral cancer patients.
- The necessity of contralateral neck irradiation is debated.
- This study assesses unilateral neck irradiation's effectiveness and identifies recurrence predictors.
Purpose of the Study:
- To evaluate the efficacy of unilateral neck irradiation in oral cancer.
- To identify risk factors for contralateral neck recurrence.
- To analyze recurrence patterns and late adverse events.
Main Methods:
- Retrospective analysis of 85 oral cancer patients treated with unilateral neck irradiation (2010-2023).
- Kaplan-Meier method for survival rates (INCR, NCR, PFS, OS).
- Log-rank and Cox regression for two-year contralateral neck control rate (CNCR).
Main Results:
- Two-year rates: INCR 85%, NCR 77%, PFS 69%, OS 82%.
- 36.5% experienced recurrence; 12.9% had contralateral recurrence.
- Poorer CNCR linked to ≥5 metastatic lymph nodes, ≥T2 tumors, and newly diagnosed status.
Conclusions:
- Unilateral neck irradiation appears effective for specific oral cancer patients.
- Favorable candidates include those with fewer metastatic lymph nodes, lower T stage, or recurrent disease.
- This strategy may reduce the need for bilateral irradiation in select cases.
