Analysis of prognostic factors in patients with oropharyngeal squamous cell carcinoma treated with radiotherapy alone or in combination with systemic chemotherapy.
OBJECTIVE
To assess the prognostic significance of several factors in oropharyngeal squamous cell carcinoma treated with radiotherapy alone or in combination with chemotherapy.


METHODS
Retrospective study.


METHODS
Erasto Gaertner Hospital, Curitiba, Brazil, and A. C. Camargo Hospital, São Paulo, Brazil.


METHODS
A total of 361 patients treated for squamous cell carcinoma from January 1, 1990, to December 31, 2001.


METHODS
Radiotherapy alone or with chemotherapy.


METHODS
Disease-free survival, overall survival, and treatment response.


RESULTS
Most tumors were located at the tonsil (46.8%) or base of the tongue (28.0%) and were at clinical stage III or IV (92.8%). Treatment response was associated with Zubrod scale score, weight loss, number of comorbidities, symptom-severity and Piccirillo stages, hemoglobin level, tumor site, macroscopic appearance of the tumor, and clinical stage. The 5-year overall survival rate was 17.6% and disease-free survival rate was 16.2%. The significant prognostic variables were age; Zubrod scale score; weight loss; comorbidities; Berg, Piccirillo, and symptom-severity staging; involvement of adjacent soft-tissue areas and bone; lymph node mobility; clinical stage; and radiotherapy doses. The multivariate analysis showed Zubrod scale score, symptom-severity staging system, Berg staging system, comorbidities, and radiotherapy dose as independent prognostic factors.


CONCLUSIONS
A combination of clinical factors, such as symptoms, patients' general status, weight loss, and comorbidities, leads to a relevant stage of clinical severity that can be associated with the TNM stage as predictors of survival in oropharyngeal carcinoma.
Pedruzzi
Paola A G
PA
Department of Head and Neck Surgery, Erasto Gaertner Hospital, Curitiba, Brazil.
Kowalski
Luiz P
LP
Nishimoto
Ines N
IN
Oliveira
Benedito V
BV
Tironi
Fabio
F
Ramos
Gyl H A
GH
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D014062:Tongue Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy; D014067:Tonsillar Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy