title: Intensity-modulated radiotherapy improves outcomes in postoperative patients with squamous cell carcinoma of the oral cavity.
abstract: OBJECTIVE
  We compared the outcomes and survival rates of patients with oral cavity squamous cell carcinoma receiving postoperative conventional radiotherapy (RT) or intensity-modulated radiotherapy (IMRT).
  
  
  METHODS
  From January 2005 to September 2008, medical records of 131 consecutive patients with oral cancer receiving postoperative radiotherapy in the Department of Radiation Oncology of National Cheng Kung University Hospital were reviewed. Patients were divided into two groups according to the administration of postoperative conventional RT or IMRT. The loco-regional control, survival, and other prognostic factors were compared.
  
  
  RESULTS
  The 3-year Kaplan-Meier estimates of overall survival for patients receiving conventional RT and IMRT groups were 51.2% vs. 69.4% (p=0.079), respectively. The 3-year local-regional control (53.5% vs. 76.3%; p=0.020) and disease-free survival rates (47.8% vs. 70.0%; p=0.027) were significantly increased in the IMRT group. This retrospective study also identified that extracapsular spreading, margin positive/close (≤ 2mm), more advanced T stage (T3-4 vs. T1-2), and conventional RT method were associated with worse prognosis.
  
  
  CONCLUSIONS
  The addition of chemotherapy to adjuvant radiotherapy is recommended in patients with above risk factors. Our result underscores that IMRT should be considered to apply to OSCC patients referred for postoperative treatment.
authors.affiliation: Department of Radiation Oncology, Sinlau Christian Hospital, Tainan, Taiwan; Department of Radiation Oncology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No. 138 Cheng-Li Road, Tainan, Taiwan.
authors.forename: Pang-Yu
authors.initials: PY
authors.lastname: Chen
authors.forename: Helen H W
authors.initials: HH
authors.lastname: Chen
authors.forename: Jenn-Ren
authors.initials: JR
authors.lastname: Hsiao
authors.forename: Ming-Wei
authors.initials: MW
authors.lastname: Yang
authors.forename: Wei-Ting
authors.initials: WT
authors.lastname: Hsueh
authors.forename: Sen-Tien
authors.initials: ST
authors.lastname: Tasi
authors.forename: Forn-Chia
authors.initials: FC
authors.lastname: Lin
authors.forename: Yuan-Hua
authors.initials: YH
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality / Q000532:radiotherapy* / Q000601:surgery; D011184:Postoperative Period; D018714:Radiotherapy, Adjuvant; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult