title: Definitive intensity-modulated radiotherapy concurrent with systemic therapy for oropharyngeal squamous cell carcinoma: Outcomes from an integrated regional Australian cancer centre.
abstract: BACKGROUND
  Oropharyngeal squamous cell carcinoma (OPSCC) incidence has increased over the past two decades largely because of an increase in human papilloma virus (HPV)-related OPSCC. We report here outcomes of definitive radiation therapy for OPSCC with simultaneous integrated boost intensity-modulated radiotherapy (IMRT) in a regional Australian cancer centre.
  
  
  METHODS
  We retrospectively reviewed electronic medical records (EMR) of all patients treated with IMRT for head and neck cancer. We included patients who received a curative intent IMRT for OPSCC (2010-2014).
  
  
  RESULTS
  Of 61 patients, 80% were men, and the median age was 57 years. Ninety percent of our patients received concurrent systemic therapy, and 68% were p16 positive. The median radiotherapy dose received was 70 Gy in 35 fractions. The median follow up for surviving patients was 22 months. Twenty-four month actuarial data show that the loco-regional recurrence free, metastasis-free MFS, cancer-specific (CaSS) and overall survival percentages were 98.3%, 92.6%, 91% and 90.3%, respectively. We did not observe grades 4 or 5 acute or late toxicities, and 10 patients (16.2%) exhibited persistent grade 3 toxicity 6 months after completing the treatment.
  
  
  CONCLUSIONS
  The results from curative IMRTs for OPSCC delivered in a regional cancer centre are comparable with results published by tertiary referral centres. A long-term follow up of this patient cohort will continue for further analyses and comparisons with tertiary centres.
authors.affiliation: Radiation Oncologist, North Coast Cancer Institute, Lismore, New South Wales, Australia.
authors.forename: Reza
authors.initials: R
authors.lastname: Masoud Rahbari
authors.affiliation: Senior Radiation Therapist, North Coast Cancer Institute, Port Macquarie, New South Wales, Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Winkley
authors.affiliation: Radiation Oncologist, North Coast Cancer Institute, Port Macquarie, New South Wales, Australia.
authors.forename: Jacques
authors.initials: J
authors.lastname: Hill
authors.affiliation: Radiation Oncologist, North Coast Cancer Institute, Coffs Harbour, New South Wales, Australia.
authors.forename: Abdul Rahim Mohammed
authors.initials: AR
authors.lastname: Tahir
authors.affiliation: Radiation Oncologist, North Coast Cancer Institute, Lismore, New South Wales, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: McKay
authors.affiliation: Radiation Oncologist, North Coast Cancer Institute, Port Macquarie, New South Wales, Australia.
authors.forename: Andrew
authors.initials: A
authors.lastname: Last
authors.affiliation: Radiation Oncologist, North Coast Cancer Institute, Coffs Harbour, New South Wales, Australia.|Rural Clinical School, The University of New South Wales, Sydney, New South Wales, Australia.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Shakespeare
authors.affiliation: Radiation Oncologist, North Coast Cancer Institute, Lismore, New South Wales, Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: Dwyer
mesh_terms: D001315:Australia; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009959:Oropharyngeal Neoplasms / Q000401:mortality / Q000532:radiotherapy*; D011878:Radiotherapy; D050397:Radiotherapy, Intensity-Modulated; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: IMRT; head and neck; oropharyngeal cancer; outcomes; quality assurance; regional centre