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| |  ESTRO: Oral Squamous Cell Carcinoma: Reducing Postoperative Radiotherapy Treatment Time Improves Locoregional Control By Adrian Burton Special to DG News PRAGUE, CZECH REPUBLIC -- September 23, 2002 -- Reducing radiotherapy treatment time to six weeks from eight weeks or more leads to an appreciable improvement in the locoregional control (LRC) of postoperative oral squamous cell carcinoma. That finding was presented at a meeting of the European Society of Therapeutic Radiology and Oncology. "In the primary radiotherapy treatment of oral squamous cell cancer we know that overall treatment time has a tremendous effect on locoregional control--the longer the treatment the worse the results are," said Johannes Langendijk, Associate Professor of Radiation Oncology at the Vrije Universiteit, Amsterdam, here in Prague today. "In the post-operative setting, however, the importance of radiotherapy treatment time is less clear. The studies performed have been with small numbers of patients. We tried to identify what was better with a much bigger sample." The study subjects included 217 patients with previously untreated oral squamous cell carcinoma who received radical surgery and post-operative radiotherapy. Retrospective analysis of patient data showed that there was a significant difference in LRC depending on overall radiotherapy treatment time (ORTT). Five year LRC was 87 percent, 72 percent, 69 percent and 51 percent when ORTT was less than 6 weeks, 6-7 weeks, 7-8 weeks and more than 8 weeks respectively (p=0.0005). Further, overall survival increased from 56 percent to 68 percent when ORTT was reduced from more than 8 weeks to less than 6 weeks. Disease free survival figures faired similarly. Reducing the ORTT was also found to be a significant factor in the LRC, overall survival and disease free survival rates of patients classed as having either a high or intermediate risk of recurrence. (High risk was defined as extracapsular extension and/or microscopic disease plus two or more other risk factors, such as high T or N stage or perineural growth. Intermediate risk was defined as one risk factor). "Because this was a retrospective study, it was difficult to see if toxicity increased with the shortened schedules," explained Dr. Langendijk. "But what we did find was that the ORTT was the single most important factor influencing locoregional control and overall survival. The main message is that ORTT is really very important. We need to aim to get radiation therapy over with by six weeks with no interruptions."
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