Adjuvant Radiotherapy in Patients with Squamous Cell Carcinoma of the Oral Cavity or Oropharynx and Solitary Ipsilateral Lymph Node Metastasis (pN1)-A Prospective Multicentric Cohort Study
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Adjuvant Radiotherapy in Patients with Squamous Cell Carcinoma of the Oral Cavity or Oropharynx and Solitary Ipsilateral Lymph Node Metastasis (pN1)-A Prospective Multicentric Cohort Study. / Kämmerer, Peer W; Tribius, Silke; Cohrs, Lena; Engler, Gabriel; Ettl, Tobias; Freier, Kolja; Frerich, Bernhard; Ghanaati, Shahram; Gosau, Martin; Haim, Dominik; Hartmann, Stefan; Heiland, Max; Herbst, Manuel; Hoefert, Sebastian; Hoffmann, Jürgen; Hölzle, Frank; Howaldt, Hans-Peter; Kreutzer, Kilian; Leonhardt, Henry; Lutz, Rainer; Moergel, Maximilian; Modabber, Ali; Neff, Andreas; Pietzka, Sebastian; Rau, Andrea; Reichert, Torsten E; Smeets, Ralf; Sproll, Christoph; Steller, Daniel; Wiltfang, Jörg; Wolff, Klaus-Dietrich; Kronfeld, Kai; Al-Nawas, Bilal.
In: CANCERS, Vol. 15, No. 6, 1833, 18.03.2023.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Adjuvant Radiotherapy in Patients with Squamous Cell Carcinoma of the Oral Cavity or Oropharynx and Solitary Ipsilateral Lymph Node Metastasis (pN1)-A Prospective Multicentric Cohort Study
AU - Kämmerer, Peer W
AU - Tribius, Silke
AU - Cohrs, Lena
AU - Engler, Gabriel
AU - Ettl, Tobias
AU - Freier, Kolja
AU - Frerich, Bernhard
AU - Ghanaati, Shahram
AU - Gosau, Martin
AU - Haim, Dominik
AU - Hartmann, Stefan
AU - Heiland, Max
AU - Herbst, Manuel
AU - Hoefert, Sebastian
AU - Hoffmann, Jürgen
AU - Hölzle, Frank
AU - Howaldt, Hans-Peter
AU - Kreutzer, Kilian
AU - Leonhardt, Henry
AU - Lutz, Rainer
AU - Moergel, Maximilian
AU - Modabber, Ali
AU - Neff, Andreas
AU - Pietzka, Sebastian
AU - Rau, Andrea
AU - Reichert, Torsten E
AU - Smeets, Ralf
AU - Sproll, Christoph
AU - Steller, Daniel
AU - Wiltfang, Jörg
AU - Wolff, Klaus-Dietrich
AU - Kronfeld, Kai
AU - Al-Nawas, Bilal
PY - 2023/3/18
Y1 - 2023/3/18
N2 - (1) Background: Evaluation of impact of adjuvant radiation therapy (RT) in patients with oral squamous cell carcinoma of the oral cavity/oropharynx (OSCC) of up to 4 cm (pT1/pT2) and solitary ipsilateral lymph node metastasis (pN1). A non-irradiated group with clinical follow-up was chosen for control, and survival and quality of life (QL) were compared; (2) Methods: This prospective multicentric comprehensive cohort study included patients with resected OSCC (pT1/pT2, pN1, and cM0) who were allocated into adjuvant radiation therapy (RT) or observation. The primary endpoint was overall survival. Secondary endpoints were progression-free survival and QL after surgery; (3) Results: Out of 27 centers, 209 patients were enrolled with a median follow-up of 3.4 years. An amount of 137 patients were in the observation arm, and 72 received adjuvant irradiation. Overall survival did not differ between groups (hazard ratio (HR) 0.98 [0.55-1.73], p = 0.94). There were fewer neck metastases (HR 0.34 [0.15-0.77]; p = 0.01), as well as fewer local recurrences (HR 0.41 [0.19-0.89]; p = 0.02) under adjuvant RT. For QL, irradiated patients showed higher values for the symptom scale pain after 0.5, two, and three years (all p < 0.05). After six months and three years, irradiated patients reported higher symptom burdens (impaired swallowing, speech, as well as teeth-related problems (all p < 0.05)). Patients in the RT group had significantly more problems with mouth opening after six months, one, and two years (p < 0.05); (4) Conclusions: Adjuvant RT in patients with early SCC of the oral cavity and oropharynx does not seem to influence overall survival, but it positively affects progression-free survival. However, irradiated patients report a significantly decreased QL up to three years after therapy compared to the observation group.
AB - (1) Background: Evaluation of impact of adjuvant radiation therapy (RT) in patients with oral squamous cell carcinoma of the oral cavity/oropharynx (OSCC) of up to 4 cm (pT1/pT2) and solitary ipsilateral lymph node metastasis (pN1). A non-irradiated group with clinical follow-up was chosen for control, and survival and quality of life (QL) were compared; (2) Methods: This prospective multicentric comprehensive cohort study included patients with resected OSCC (pT1/pT2, pN1, and cM0) who were allocated into adjuvant radiation therapy (RT) or observation. The primary endpoint was overall survival. Secondary endpoints were progression-free survival and QL after surgery; (3) Results: Out of 27 centers, 209 patients were enrolled with a median follow-up of 3.4 years. An amount of 137 patients were in the observation arm, and 72 received adjuvant irradiation. Overall survival did not differ between groups (hazard ratio (HR) 0.98 [0.55-1.73], p = 0.94). There were fewer neck metastases (HR 0.34 [0.15-0.77]; p = 0.01), as well as fewer local recurrences (HR 0.41 [0.19-0.89]; p = 0.02) under adjuvant RT. For QL, irradiated patients showed higher values for the symptom scale pain after 0.5, two, and three years (all p < 0.05). After six months and three years, irradiated patients reported higher symptom burdens (impaired swallowing, speech, as well as teeth-related problems (all p < 0.05)). Patients in the RT group had significantly more problems with mouth opening after six months, one, and two years (p < 0.05); (4) Conclusions: Adjuvant RT in patients with early SCC of the oral cavity and oropharynx does not seem to influence overall survival, but it positively affects progression-free survival. However, irradiated patients report a significantly decreased QL up to three years after therapy compared to the observation group.
U2 - 10.3390/cancers15061833
DO - 10.3390/cancers15061833
M3 - SCORING: Journal article
C2 - 36980719
VL - 15
JO - CANCERS
JF - CANCERS
SN - 2072-6694
IS - 6
M1 - 1833
ER -