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Short-Term Symptom and Functional Outcomes Following Definitive Chemoradiotherapy Versus Surgery Plus Adjuvant
Sabrina Taher1, Anowarul Islam2, Altaf Hossain3
1Radiation Oncology, Evercare Hospital Dhaka, Dhaka, BGD.
Cureus
|August 1, 2026
Summary
Both definitive concurrent chemoradiotherapy (CCRT) and surgery with adjuvant radiotherapy (RT) improved symptom burden in locally advanced oral cavity squamous cell carcinoma (OCSCC) patients. Short-term functional outcomes showed no significant difference between these OCSCC treatment approaches.
Area of Science:
- Oncology
- Head and Neck Surgery
- Radiation Oncology
Background:
- Locally advanced oral cavity squamous cell carcinoma (OCSCC) significantly impacts patient quality of life, affecting eating, swallowing, and daily function.
- Standard treatment involves surgery followed by adjuvant radiotherapy (RT), with definitive concurrent chemoradiotherapy (CCRT) reserved for select patients.
- Comparing symptom burden and functional outcomes between these treatment modalities is crucial for optimizing patient care.
Purpose of the Study:
- To prospectively compare short-term symptom burden and functional outcomes in patients with locally advanced OCSCC.
- To evaluate the efficacy of definitive CCRT versus surgery followed by adjuvant RT in managing patient-reported symptoms.
Main Methods:
- A prospective, non-randomized comparative cohort study included 68 patients with stage III or IVA OCSCC.
- Patients were divided into two groups: 34 receiving definitive CCRT and 34 undergoing surgery plus adjuvant RT.
- Symptom burden and functional status were assessed using the Functional Assessment of Cancer Therapy Head and Neck Symptom Index-10 (FACT-HNSI-10).
Main Results:
- Both treatment groups demonstrated significant short-term improvements in symptom burden, as indicated by decreased FACT-HNSI-10 scores (p<0.001).
- No statistically significant difference in the mean change of symptom burden was observed between the definitive CCRT and surgery plus adjuvant RT groups (p=0.471).
- Improvements were noted across pain, dysphagia, bleeding/ulceration, and respiratory distress in both treatment arms.
Conclusions:
- Both definitive CCRT and surgery followed by adjuvant RT offer comparable short-term symptom relief and functional improvement for locally advanced OCSCC.
- Findings suggest similar short-term efficacy in symptom management, though oncologic equivalence is not established.
- Further research with larger sample sizes and longer follow-up is warranted due to study limitations.
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