title: Five-year follow-up of concomitant accelerated hypofractionated radiation in advanced squamous cell carcinoma of the buccal mucosa: a retrospective cohort study.
abstract: In resource limited settings, induction chemotherapy with Gemcitabine and Cisplatinum and concurrent hypofractionated chemoradiation for locally advanced carcinoma of buccal mucosa (BMSCC) are a cost effective option but remain under reported. The objective of this study was to report long term survival outcome after concurrent hypofractionated radiotherapy in locally advanced BMSCC. Between February 2005 and 2009, 63 patients received treatment. Induction chemotherapy (IC) regimen consisted of two drugs: Gemcitabine and Cisplatin. All patients received 55 Gy of radiation in 20 fractions with concurrent single agent Cisplatin (75 mg/m(2)). Five-year overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS) were determined. Based on AJCC staging, 7 (11%) patients were stage III, 31 (49%) stage IV a, and 25 (40%) stage IVb at presentation. After IC, 8 (18%) patients had complete radiological response, 33 (73%) had partial response, and 4 (9%) had stable disease. After concurrent hypofractionated chemoradiation, thirty-nine (62%) patients were complete responders and 24 (38%) had stable disease. With a minimum follow-up of 60 months, 5-year OS, DFS, and PFS were 30%, 49%, and 30%, respectively. In locally advanced buccal mucosa squamous cell carcinoma, concurrent hypofractionated chemoradiation results in acceptable survival and regimen related toxicity.
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
authors.forename: Hassan
authors.initials: H
authors.lastname: Iqbal
authors.affiliation: Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
authors.forename: Arif
authors.initials: A
authors.lastname: Jamshed
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
authors.forename: Abu Bakar Hafeez
authors.initials: AB
authors.lastname: Bhatti
authors.affiliation: Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
authors.forename: Raza
authors.initials: R
authors.lastname: Hussain
authors.affiliation: Aga khan University, Karachi, Pakistan.
authors.forename: Sarah
authors.initials: S
authors.lastname: Jamshed
authors.affiliation: Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Irfan
authors.affiliation: Lahore Medical and Dental College, Lahore, Pakistan.
authors.forename: Natasha
authors.initials: N
authors.lastname: Hameed
authors.affiliation: Department of Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
authors.forename: Adeel
authors.initials: A
authors.lastname: Illyas
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000628:therapy; D002945:Cisplatin / Q000008:administration & dosage*; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa; D009062:Mouth Neoplasms / Q000401:mortality / Q000628:therapy; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D015996:Survival Rate; D000093542:Gemcitabine
chemical_list: D003841:Deoxycytidine; D002945:Cisplatin; D000093542:Gemcitabine