title: Treatment outcome of combined modalities for buccal cancers: unilateral or bilateral neck radiation?
abstract: OBJECTIVE
  To evaluate the outcome of treatment for buccal cancers and assess the impact of unilateral vs. bilateral adjuvant neck radiation.
  
  
  METHODS
  We retrospectively reviewed the course of 145 patients newly diagnosed with buccal squamous cell carcinoma without distant metastases who completed definitive treatment between January 1994 and December 2000. Of 145 patients, 112 (77%) had Stage III or IV disease. All underwent radical surgery with postoperative radiotherapy (median dose, 64 Gy), including unilateral neck treatment in most (n = 120, 82.8%). After 1997, cisplatin-based concomitant chemoradiotherapy was given for high-risk patients with more than two involved lymph nodes, extracapsular spread, and/or positive margins.
  
  
  RESULTS
  The 5-year disease-specific survival rate for Stages I-IV was 87%, 83%, 61%, and 60%, respectively (p = 0.01). The most significant prognostic factor was N stage, with the 5-year disease-specific survival rate for N0, N1, and N2 being 79%, 65%, and 54%, respectively (p = 0.001). For patients with more than two lymph nodes or positive extracapsular spread, cisplatin-based concomitant chemoradiotherapy improved locoregional control (p = 0.02). Locoregional control did not differ between patients undergoing unilateral or bilateral neck treatments (p = 0.95). Contralateral neck failure occurred in only 2.1%.
  
  
  CONCLUSIONS
  In patients with buccal carcinoma after radical resection, ipsilateral neck radiation is adequate. Bilateral prophylactic neck treatment does not confer an added benefit.
authors: Department of Radiation Oncology, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
authors: Chien-Yu
authors: CY
authors: Lin
authors: Li-Yu
authors: LY
authors: Lee
authors: Shiang-Fu
authors: SF
authors: Huang
authors: Chung-Jan
authors: CJ
authors: Kang
authors: Kang-Hsing
authors: KH
authors: Fan
authors: Hung-Ming
authors: HM
authors: Wang
authors: Eric Yen-Chao
authors: EY
authors: Chen
authors: I-How
authors: IH
authors: Chen
authors: Chun-Ta
authors: CT
authors: Liao
authors: Ann-Joy
authors: AJ
authors: Cheng
authors: Joseph Tung-Chieh
authors: JT
authors: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy* / Q000628:therapy; D037981:Neck Dissection / Q000379:methods; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome