title: Acute toxicities of adjuvant treatment in patients of oral squamous cell carcinoma with and without submucous fibrosis: A retrospective audit.
abstract: OBJECTIVE
  To assess the severity of acute toxicities of postoperative adjuvant therapy on oral squamous cell carcinoma (OSCC) patients with and without submucous fibrosis (SMF).
  
  
  METHODS
  The study population comprised treatment naïve OSCC patients who underwent curative intent surgical resection from June 2010 to April 2011 followed by adjuvant treatment. Patients whose treatment details including toxicity profile were available were included in the study. One-hundred nine patients met the inclusion criteria of whom 36 had associated SMF and 73 no SMF. Overall, 35 patients received chemotherapy (CT) with radiotherapy (RT) and the rest only RT. Forty-two patients had centralized and 67 lateralized lesions. All patients with centralized lesions and 3 with lateralized lesion received radiation to bilateral face and neck. All others received ipsilateral radiation. The severity of mucositis, xerostomia, and skin toxicity (as per radiation therapy oncology group scale of acute toxicity) was compared between the SMF and non-SMF groups and patients with centralized and lateralized lesions.
  
  
  RESULTS
  CT in addition to RT did not add significant to the assessed toxicities. Severe mucositis as well as treatment breaks were more in SMF group as compared to non-SMF group (P = 0.001 and <0.001 respectively). Severe mucositis and xerostomia were more in centralized than in lateralized lesions (P = 0.002 and 0.00 respectively). In subgroups of lateralized as well as centralized lesions, severe mucositis was more common in SMF patients than those without SMF (P = 0.01 and 0.02 respectively).
  
  
  CONCLUSIONS
  OSCC patients with SMF have worse toxicity with adjuvant therapy and require good supportive care.
authors.affiliation: Department of Head and Neck Surgery, TATA Memorial Hospital, Parel, Mumbai, Maharashtra, India.
authors.forename: Swagnik
authors.initials: S
authors.lastname: Chakrabarti
authors.affiliation: Department of Head and Neck Surgery, TATA Memorial Hospital, Parel, Mumbai, Maharashtra, India.
authors.forename: Aseem
authors.initials: A
authors.lastname: Mishra
authors.affiliation: Department of Radiation Oncology, TATA Memorial Hospital, Parel, Mumbai, Maharashtra, India.
authors.forename: Jai Prakash
authors.initials: JP
authors.lastname: Agarwal
authors.affiliation: Department of Head and Neck Surgery, TATA Memorial Hospital, Parel, Mumbai, Maharashtra, India.
authors.forename: Apurva
authors.initials: A
authors.lastname: Garg
authors.affiliation: Department of Head and Neck Surgery, TATA Memorial Hospital, Parel, Mumbai, Maharashtra, India.
authors.forename: Deepa
authors.initials: D
authors.lastname: Nair
authors.affiliation: Department of Head and Neck Surgery, TATA Memorial Hospital, Parel, Mumbai, Maharashtra, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Chaturvedi
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D005355:Fibrosis; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D009062:Mouth Neoplasms / Q000473:pathology* / Q000628:therapy*; D020360:Neoadjuvant Therapy / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome