title: Guideline and preliminary clinical practice results for dose specification and target delineation for postoperative radiotherapy for oral cavity cancer.
abstract: BACKGROUND
  Surgery followed by radiotherapy (RT) is indicated for patients with high-risk oral cavity cancer (OCC). Based on multi-institutional reports, we developed a guideline for postoperative RT for patients with OCC.
  
  
  METHODS
  A multidisciplinary OCC team was recruited to develop a questionnaire concerning details of risk-factor categorization, target delineation, and dose specification. Thirty-one radiation oncologists from 18 institutions completed the questionnaire, and data were subjected to extensive review to establish the guideline by expert meeting. In this study, we also report the results for patients treated in accordance with the guideline at our institution between 2007 and 2011.
  
  
  RESULTS
  Forty-one patients received RT compatible with this guideline with a median 26.8-month follow-up. Thirty-two patients (78%) remained disease-free, 6 (15%) developed locoregional recurrence (4 in-field, 1 marginal, and 1 out-field) and 4 (10%) developed distant metastasis. The overall 2-year survival rate was 86.7%.
  
  
  CONCLUSIONS
  This guideline is promising and should be validated and refined in further clinical practice.
authors.affiliation: Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Shih-Hua
authors.initials: SH
authors.lastname: Liu
authors.affiliation: Department of Radiation Oncology, Columbia University, New York, New York.
authors.forename: K S Clifford
authors.initials: KS
authors.lastname: Chao
authors.affiliation: Department of Otolaryngology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Yi-Shing
authors.initials: YS
authors.lastname: Leu
authors.affiliation: Department of Otolaryngology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Jehn-Chuan
authors.initials: JC
authors.lastname: Lee
authors.affiliation: Department of Oral Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Chung-Ji
authors.initials: CJ
authors.lastname: Liu
authors.affiliation: Graduate Institute of Chinese Medical Science, China Medical University, Taichung, Taiwan.
authors.forename: Yu-Chuen
authors.initials: YC
authors.lastname: Huang
authors.affiliation: Department of Medical Oncology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Yi-Fang
authors.initials: YF
authors.lastname: Chang
authors.affiliation: Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Hong-Wen
authors.initials: HW
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Taipei Medical University-Shuang Ho Hospital, Taipei, Taiwan.
authors.forename: Jo-Ting
authors.initials: JT
authors.lastname: Tsai
authors.affiliation: Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan.
authors.forename: Yu-Jen
authors.initials: YJ
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000473:pathology; D009062:Mouth Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011184:Postoperative Period; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: dose specification; guideline; oral cavity cancer; postoperative radiotherapy; target delineation