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 PW, Tribius S, Cohrs L, Engler G, Ettl T, Freier K, Frerich B, Ghanaati S, Gosau M, Haim D, Hartmann S, Heiland M, Herbst M, Hoefert S, Hoffmann J, Hölzle F, Howaldt HP, Kreutzer K, Leonhardt H, Lutz R, Moergel M, Modabber A, Neff A, Pietzka S, Rau A, Reichert TE, Smeets R, Sproll C, Steller D, Wiltfang J, Wolff KD, Kronfeld K, Al-Nawas B (2023)

Publication Type: Journal article

Publication year: 2023

Journal

Book Volume: 15

Article Number: 1833

Journal Issue: 6

DOI: 10.3390/cancers15061833

Abstract

(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.

Authors with CRIS profile

Involved external institutions

Universitätsklinikum Gießen und Marburg (UKGM) Germany (DE) Universität Regensburg Germany (DE) Universitätsklinikum des Saarlandes (UKS) Germany (DE) Universitätsmedizin Rostock Germany (DE) Universitätsklinikum Frankfurt am Main (KGU) Germany (DE) Universitätsklinikum Hamburg-Eppendorf (UKE) Germany (DE) Universitätsklinikum Carl Gustav Carus Dresden Germany (DE) Universitätsklinikum Würzburg Germany (DE) Berliner Institut für Gesundheitsforschung (BIH) Germany (DE) Universitätsmedizin der Johannes Gutenberg-Universität Mainz Germany (DE) Universitätsklinikum Tübingen Germany (DE) Universitätsklinikum Heidelberg Germany (DE) Universitätsklinikum Aachen (UKA) Germany (DE) Universitätsklinikum Ulm Germany (DE) Heinrich-Heine-Universität Düsseldorf Germany (DE) Universitätsklinikum Schleswig-Holstein (UKSH) Germany (DE) Klinikum rechts der Isar Germany (DE) Justus-Liebig-Universität Gießen Germany (DE) Universitätsmedizin Greifswald / Universitätsklinikum Greifswald Germany (DE)

How to cite

APA:

Kämmerer, P.W., Tribius, S., Cohrs, L., Engler, G., Ettl, T., Freier, K.,... Al-Nawas, B. (2023). 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. Cancers, 15(6). https://doi.org/10.3390/cancers15061833

MLA:

Kämmerer, Peer W., et al. "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." Cancers 15.6 (2023).

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