title: Clinical effectiveness, toxicity, and failure patterns of helical tomotherapy for postoperative oral cavity cancer patients.
abstract: BACKGROUND
  The outcome of postoperative high- and intermediate-risk oral cavity cancer (OCC) patients receiving helical tomotherapy (HT) remains limited.
  
  
  METHODS
  Between November 2006 and November 2012, 53 postoperative high- and intermediate-risk OCC patients treated with HT were enrolled.
  
  
  RESULTS
  The 4-year locoregional, local, and regional control rates were 66%, 76.4%, and 94.3%, respectively. The 4-year locoregional control rates of oral tongue and buccal mucosa cancer were 88.3% and 37.1%, respectively (P=0.012). Eleven (20.8%) patients experienced locoregional failure. In-field failure occurred in six of 53 (11.3%) in the primary area and three of 53 (5.7%) in the regional lymph-node area. No marginal failure was noted. Two of 53 (3.8%) experienced out-of-field failure. The rates of grade 3 dermatitis, mucositis, and dysphagia were 11%, 34%, and 13%, respectively. No grade 3 xerostomia was noted. Grade 2 xerostomia was 33% at month 6 and declined to 0 at month 48. A rate of 56% of grade 2 trismus at month 6 was noted, and declined to around 30% after 2 years. No grade 3 trismus was noted after 2 years.
  
  
  CONCLUSIONS
  HT as a postoperative modality provided satisfying results, especially for xerostomia and trismus, and was impressive in high- and intermediate-risk OCC patients receiving postoperative HT.
authors.affiliation: Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan ; Department of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan ; Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chen-Hsi
authors.initials: CH
authors.lastname: Hsieh
authors.affiliation: Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan ; Department of Radiation Oncology, National Defense Medical Center, Taipei, Taiwan.
authors.forename: Pei-Wei
authors.initials: PW
authors.lastname: Shueng
authors.affiliation: School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
authors.forename: Li-Ying
authors.initials: LY
authors.lastname: Wang
authors.affiliation: Department of Otolaryngology, Oriental Institute of Technology, Taipei, Taiwan.
authors.forename: Li-Jen
authors.initials: LJ
authors.lastname: Liao
authors.affiliation: Division of Medical Oncology and Hematology, Department of Internal Medicine, Oriental Institute of Technology, Taipei, Taiwan.
authors.forename: Yu-Chin
authors.initials: YC
authors.lastname: Lin
authors.affiliation: Department of Dentistry and Oral Surgery, Oriental Institute of Technology, Taipei, Taiwan.
authors.forename: Ying-Shiung
authors.initials: YS
authors.lastname: Kuo
authors.affiliation: Department of Otolaryngology, Oriental Institute of Technology, Taipei, Taiwan.
authors.forename: Wu-Chia
authors.initials: WC
authors.lastname: Lo
authors.affiliation: Department of Dentistry and Oral Surgery, Oriental Institute of Technology, Taipei, Taiwan.
authors.forename: Chien-Fu
authors.initials: CF
authors.lastname: Tseng
authors.affiliation: Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Hui-Ju
authors.initials: HJ
authors.lastname: Tien
authors.affiliation: Department of Nursing, Far Eastern Memorial Hospital, Oriental Institute of Technology, Taipei, Taiwan ; Department of Nursing, Oriental Institute of Technology, Taipei, Taiwan.
authors.forename: Hsiu-Ling
authors.initials: HL
authors.lastname: Chou
authors.affiliation: Department of Senior Citizen Service Management, National Taichung University of Science and Technology, Taichung, Taiwan.
authors.forename: Yen-Ping
authors.initials: YP
authors.lastname: Hsieh
authors.affiliation: Department of Radiation Oncology, Far Eastern Memorial Hospital, Taipei, Taiwan.
authors.forename: Le-Jung
authors.initials: LJ
authors.lastname: Wu
authors.affiliation: Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan ; Department of Radiation Oncology, Mackay Memorial Hospital, Taipei, Taiwan ; Department of Medical Research, Mackay Memorial Hospital, Taipei, Taiwan ; Graduate Institute of Sport Coaching Science, Chinese Culture University, Taipei, Taiwan.
authors.forename: Yu-Jen
authors.initials: YJ
authors.lastname: Chen
keywords: concurrent chemoradiation; helical tomotherapy; locoregional control rate; oral cavity cancer; trismus