Cancers (Mar 2023)
Adjuvant Radiotherapy in Patients with Squamous Cell Carcinoma of the Oral Cavity or Oropharynx and Solitary Ipsilateral Lymph Node Metastasis (pN1)—A Prospective Multicentric Cohort Study
- Peer W. Kämmerer,
- Silke Tribius,
- Lena Cohrs,
- Gabriel Engler,
- Tobias Ettl,
- Kolja Freier,
- Bernhard Frerich,
- Shahram Ghanaati,
- Martin Gosau,
- Dominik Haim,
- Stefan Hartmann,
- Max Heiland,
- Manuel Herbst,
- Sebastian Hoefert,
- Jürgen Hoffmann,
- Frank Hölzle,
- Hans-Peter Howaldt,
- Kilian Kreutzer,
- Henry Leonhardt,
- Rainer Lutz,
- Maximilian Moergel,
- Ali Modabber,
- Andreas Neff,
- Sebastian Pietzka,
- Andrea Rau,
- Torsten E. Reichert,
- Ralf Smeets,
- Christoph Sproll,
- Daniel Steller,
- Jörg Wiltfang,
- Klaus-Dietrich Wolff,
- Kai Kronfeld,
- Bilal Al-Nawas
Affiliations
- Peer W. Kämmerer
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- Silke Tribius
- Hermann-Holthusen-Institute for Radiation Oncology, Asklepios Hospital St. Georg, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
- Lena Cohrs
- Department of Oral & Cranio-Maxillofacial Surgery, University Hospital of Luebeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
- Gabriel Engler
- Department of Oral and Craniomaxillofacial Plastic Surgery, University of Giessen and Marburg, UKGM, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Baldingerstrasse, 35043 Marburg, Germany
- Tobias Ettl
- Department of Cranio- and Maxillofacial Surgery, Hospital of the University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
- Kolja Freier
- Department of Oral and Maxillofacial Surgery, Saarland University Medical Center, Kirrberger Str., 66424 Homburg, Germany
- Bernhard Frerich
- Department of Oral and Maxillofacial Surgery, Facial Plastic Surgery, Rostock University Medical Center, Schillingallee 35, 18057 Rostock, Germany
- Shahram Ghanaati
- Clinic for Maxillofacial and Plastic Surgery, University Hospital Frankfurt, Goethe University, Marienburgstraße 2, 60528 Frankfurt am Main, Germany
- Martin Gosau
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251 Hamburg, Germany
- Dominik Haim
- Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden, Germany
- Stefan Hartmann
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070 Würzburg, Germany
- Max Heiland
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
- Manuel Herbst
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center of the Johannes Gutenberg-University Mainz, Rhabanusstraße 4, 55118 Mainz, Germany
- Sebastian Hoefert
- Department of Oral and Maxillofacial Surgery, University Hospital of Tübingen, Osianderstraße 2-8, 72076 Tübingen, Germany
- Jürgen Hoffmann
- Department of Oral and Maxillofacial Surgery, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
- Frank Hölzle
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
- Hans-Peter Howaldt
- Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstraße 33, 35392 Gießen, Germany
- Kilian Kreutzer
- Department of Oral and Maxillofacial Surgery, Charité—Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin, Germany
- Henry Leonhardt
- Department of Oral and Maxillofacial Surgery, University Hospital Carl Gustav Carus, Fetscherstr. 74, 01307 Dresden, Germany
- Rainer Lutz
- Department of Oral and Maxillofacial Surgery, Friedrich-Alexander University Erlangen-Nürnberg, Glückstraße 11, 91054 Erlangen, Germany
- Maximilian Moergel
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- Ali Modabber
- Department of Oral and Maxillofacial Surgery, University Hospital of Aachen, Pauwelsstraße 30, 52074 Aachen, Germany
- Andreas Neff
- Department of Oral and Craniomaxillofacial Plastic Surgery, University of Giessen and Marburg, UKGM, Campus Marburg, Faculty of Medicine, Philipps-University of Marburg, Baldingerstrasse, 35043 Marburg, Germany
- Sebastian Pietzka
- Department of Oral and Maxillofacial Surgery, University Hospital Ulm, Albert-Einstein-Allee 11, 89081 Ulm, Germany
- Andrea Rau
- Department of Oral and Maxillofacial Surgery/Plastic Surgery, University Medicine Greifswald, Fleischmannstraße 8, 17489 Greifswald, Germany
- Torsten E. Reichert
- Department of Cranio- and Maxillofacial Surgery, Hospital of the University of Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
- Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20251 Hamburg, Germany
- Christoph Sproll
- Department of Oral and Maxillofacial Surgery, Heinrich Heine University Düsseldorf, Moorenstraße 5, 40225 Düsseldorf, Germany
- Daniel Steller
- Department of Oral & Cranio-Maxillofacial Surgery, University Hospital of Luebeck, Ratzeburger Allee 160, 23538 Lübeck, Germany
- Jörg Wiltfang
- Department of Oral and Maxillofacial Surgery, University Hospital of Schleswig-Holstein, Campus Kiel, Arnold-Heller-Straße 3, 24105 Kiel, Germany
- Klaus-Dietrich Wolff
- Department of Oro-Maxillofacial Surgery, University Hospital Rechts der Isar, Technical University of Munich, Langerstraße 3, 81675 München, Germany
- Kai Kronfeld
- Interdisciplinary Center for Clinical Trials, University Medical Center of the Johannes Gutenberg University, Langenbeckstraße 1, 55131 Mainz, Germany
- Bilal Al-Nawas
- Department of Oral and Maxillofacial Surgery—Plastic Operations, University Medical Center Mainz, Augustusplatz 2, 55131 Mainz, Germany
- DOI
- https://doi.org/10.3390/cancers15061833
- Journal volume & issue
-
Vol. 15,
no. 6
p. 1833
Abstract
(1) Background: Evaluation of impact of adjuvant radiation therapy (RT) in patients with oral squamous cell carcinoma of the oral cavity/oropharynx (OSCC) of up to 4 cm (pT1/pT2) and solitary ipsilateral lymph node metastasis (pN1). A non-irradiated group with clinical follow-up was chosen for control, and survival and quality of life (QL) were compared; (2) Methods: This prospective multicentric comprehensive cohort study included patients with resected OSCC (pT1/pT2, pN1, and cM0) who were allocated into adjuvant radiation therapy (RT) or observation. The primary endpoint was overall survival. Secondary endpoints were progression-free survival and QL after surgery; (3) Results: Out of 27 centers, 209 patients were enrolled with a median follow-up of 3.4 years. An amount of 137 patients were in the observation arm, and 72 received adjuvant irradiation. Overall survival did not differ between groups (hazard ratio (HR) 0.98 [0.55–1.73], p = 0.94). There were fewer neck metastases (HR 0.34 [0.15–0.77]; p = 0.01), as well as fewer local recurrences (HR 0.41 [0.19–0.89]; p = 0.02) under adjuvant RT. For QL, irradiated patients showed higher values for the symptom scale pain after 0.5, two, and three years (all p p p < 0.05); (4) Conclusions: Adjuvant RT in patients with early SCC of the oral cavity and oropharynx does not seem to influence overall survival, but it positively affects progression-free survival. However, irradiated patients report a significantly decreased QL up to three years after therapy compared to the observation group.
Keywords
