title: Definitive chemoradiation for primary oral cavity carcinoma: A single institution experience.
abstract: OBJECTIVE
  While surgery with or without adjuvant radiation therapy (RT) is the standard of care for oral cavity cancer (OCC), a select group requires nonsurgical treatment. We provide a single-institution experience using definitive chemotherapy and RT for primary OCC.
  
  
  METHODS
  We examined 73 patients with previously untreated, non-metastatic primary OCC treated definitively from 1990 to 2011. There were 39 male and 34 female, with a median age of 63 years (range, 35-89). The disease distribution was Stage I and II (7% each), Stage III (14%), and Stage IV (73%). Oral tongue was the most common (48%), followed by floor of mouth (19%), retromolar trigone (13.7%), and others (8.2%). Median tumor dose was 70 Gy. Sixty-two percent of patients (n=45) were treated with concurrent chemotherapy, predominantly platinum-based.
  
  
  RESULTS
  Median follow-up among surviving patients was 73.1 months (interquartile range 14.2-81.4 months). Actuarial 5-year overall survival was 15%. Incidences of locoregional and distant failures were 41.1% and 20.5%, respectively. Kaplan-Meier estimated 5-year rates of locoregional control and freedom from distant metastasis were 37% and 70%, respectively. Mucositis was the most common ⩾Grade 3 acute toxicity (49%). Incidences of Grade 3 late dysphagia and trismus were 15% and 13%, respectively.
  
  
  CONCLUSIONS
  This study demonstrates over 20 years of experience using definitive chemoradiation for OCC at our institution. Our results illustrate the challenges in treating patients with advanced disease who are not surgical candidates, and the need for adequate and early treatment to prevent distant disease and improve survival outcomes.
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, United States.
authors.forename: Eli D
authors.initials: ED
authors.lastname: Scher
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, United States.
authors.forename: Paul B
authors.initials: PB
authors.lastname: Romesser
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, United States.
authors.forename: Christine
authors.initials: C
authors.lastname: Chen
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, United States.
authors.forename: Felix
authors.initials: F
authors.lastname: Ho
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, United States.
authors.forename: Yen
authors.initials: Y
authors.lastname: Wuu
authors.affiliation: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, United States.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Sherman
authors.affiliation: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, United States.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Fury
authors.affiliation: Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, United States.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Wong
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, United States.
authors.forename: Sean
authors.initials: S
authors.lastname: McBride
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, United States. Electronic address: leen2@mskcc.org.
authors.forename: Nancy Y
authors.initials: NY
authors.lastname: Lee
authors.affiliation: Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, United States.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Riaz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059248:Chemoradiotherapy / Q000009:adverse effects / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D003680:Deglutition Disorders / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000401:mortality* / Q000628:therapy; D052016:Mucositis / Q000453:epidemiology; D011832:Radiation Injuries / Q000453:epidemiology; D016019:Survival Analysis; D016896:Treatment Outcome; D014313:Trismus / Q000453:epidemiology
keywords: Definitive radiation; Head and neck cancer; Oral cavity cancer