Efficacy and safety of treating T4 oral cavity tumors with primary chemoradiotherapy.
BACKGROUND
Patients with T4 oral cavity (OC) tumors are often treated with surgery followed by adjuvant chemoradiotherapy (CRT).


METHODS
We performed a retrospective review of 4 multi-institutional phase II studies estimating long-term toxicity, locoregional control (LC), progression-free survival (PFS), and overall survival (OS) of primary CRT.


RESULTS
Thirty-nine subjects were identified; 16 (42%) with bony involvement. Median radiotherapy dose delivered to primary tumor was 74 Gy. Five-year OS, PFS, and LC rates were 56%, 51%, and 75%, respectively. Sixty-nine percent of subjects with bony involvement never relapsed. Seven subjects developed osteoradionecrosis. Bone involvement with primary tumor did not appear to be associated with increased risk of death, relapse, or long-term complication.


CONCLUSIONS
These data suggest that primary CRT is an effective treatment approach in patients with T4 OC tumors including those with bony involvement producing LC, survival, and complication rates comparable to historical series. Prospective clinical trials should evaluate primary surgical versus CRT treatment in these patients.
Cohen
Ezra E W
EE
Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, Illinois, USA.
Baru
Joshua
J
Huo
Dezheng
D
Haraf
Daniel J
DJ
Crowley
Maureen
M
Witt
Mary Ellyn
ME
Blair
Elizabeth A
EA
Weichselbaum
Ralph R
RR
Rosen
Fred
F
Vokes
Everett E
EE
Stenson
Kerstin
K