title: Recurrence patterns after postoperative radiotherapy for squamous cell carcinoma of the pharynx and larynx.
abstract: CONCLUSIONS
  Distant metastasis was a major pattern of recurrence after postoperative radiotherapy (PORT) for squamous cell carcinoma (SCC) of the oropharynx, hypopharynx, and larynx. PORT provided good loco-regional control, with tolerable toxicities. Advanced pT and pN were unfavorable prognostic factors.
  
  
  OBJECTIVE
  To determine the clinical outcomes, and the patterns and risk factors for recurrence of SCCs of the oropharynx, hypopharynx, and larynx treated with surgery and PORT.
  
  
  METHODS
  We retrospectively reviewed 84 patients who received PORT after definitive surgery for SCC of the oropharynx, hypopharynx, or larynx between 2000 and 2010. The primary sites were the oropharynx in 25 patients, hypopharynx in 47 patients, and larynx in 12 patients.
  
  
  RESULTS
  The 3-year overall survival (OS), progression-free survival (PFS), and loco-regional control (LRC) rates were 64.9%, 56.7%, and 92.1%, respectively. Recurrences were observed in 27 patients: 6 patients had loco-regional recurrence and 23 patients developed distant metastasis. On multivariate analysis, pT4 and pN2c-N3 displayed significantly worse effects on OS (p = 0.02 and p < 0.01, respectively) and PFS (p = 0.02 and p < 0.001, respectively). In the acute phase, 12 patients experienced grade 3 or 4 toxicities. There were no grade 5 toxicities. Late grade 3 toxicity developed in six patients and no grade 4 or 5 toxicities were observed.
authors.affiliation: Departments of Radiation Oncology and Image-applied Therapy .
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Iizuka
authors.forename: Michio
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Haruo
authors.initials: H
authors.lastname: Inokuchi
authors.forename: Yukinori
authors.initials: Y
authors.lastname: Matsuo
authors.forename: Akira
authors.initials: A
authors.lastname: Nakamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Mizowaki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Hirano
authors.forename: Morimasa
authors.initials: M
authors.lastname: Kitamura
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tateya
authors.forename: Masahiro
authors.initials: M
authors.lastname: Hiraoka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D007822:Laryngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000473:pathology; D009367:Neoplasm Staging; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
keywords: Metastasis; postoperative radiotherapy; prognostic factors