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Prognostic factors in oropharyngeal cancer--analysis of 627 cases receiving definitive radiotherapy.

AbstractINTRODUCTION:
The aim of this retrospective analysis was to analyze the results of conventional radical radiotherapy in the treatment of oropharyngeal cancer and to identify pre-treatment and treatment-related prognostic factors for outcome.
MATERIAL AND METHODS:
The records of 627 patients with oropharyngeal cancer treated with radical radiotherapy with conventional techniques were analyzed.
RESULTS:
The median age was 56 years. History of tobacco abuse was present in 80.5%. Eighty six percent had stage III or IV disease. Radical radiotherapy alone was the treatment modality for 71.2% and concomitant or neoadjuvant chemotherapy was used in 28.8%. The 3-year local control (LC), loco-regional control (LRC), disease-free survival (DFS) and overall survival (OS) was 49%, 40.6%, 38.9% and 36.1% respectively. The 3-year DFS rates were 80.3% for stage I, 65.8% for stage II, 46.1% for stage III and 25.2% for stage IV disease. Multivariate analysis was performed for prognostic factors. Prior history of tobacco abuse was an independent prognostic factor for both DFS and LRC. Karnofsky Performance Score (KPS) < 80, higher nodal stage, lower total radiotherapy dose (<66 Gy) in those receiving > 60 Gy, and overall treatment time > 50 days were other independent prognostic factors for inferior DFS and LRC. KPS < 80, higher T stage, higher nodal stage, RT dose < 66 Gy and longer overall treatment time (>50 days) were independent prognostic factors for poorer local control.
CONCLUSIONS:
Several patient-, disease- and treatment-related variables independently affect survival outcomes after radical radiotherapy for oropharyngeal cancer. Oropharyngeal cancers in those without a history of tobacco abuse may be biologically different and more amenable to cure with radiotherapy.
AuthorsJai Prakash Agarwal, Indranil Mallick, Ritu Bhutani, Sarbani Ghosh-Laskar, Tejpal Gupta, Ashwini Budrukkar, Vedang Murthy, Manju Sengar, Ketayun A Dinshaw
JournalActa oncologica (Stockholm, Sweden) (Acta Oncol) Vol. 48 Issue 7 Pg. 1026-33 ( 2009) ISSN: 1651-226X [Electronic] England
PMID19363712 (Publication Type: Journal Article)
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Disease-Free Survival
  • Female
  • Humans
  • Karnofsky Performance Status
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoadjuvant Therapy
  • Neoplasm Staging
  • Neoplasms, Squamous Cell (mortality, pathology, radiotherapy)
  • Oropharyngeal Neoplasms (mortality, pathology, radiotherapy)
  • Prognosis
  • Radiotherapy Dosage
  • Radiotherapy, Conformal
  • Retrospective Studies
  • Smoking (adverse effects)
  • Time Factors
  • Treatment Outcome
  • Young Adult

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