Patterns of disease recurrence following treatment of oropharyngeal cancer with intensity modulated radiation therapy

Adam S. Garden, Lei Dong, William H. Morrison, Erich M. Stugis, Bonnie S. Glisson, Steven J. Frank, Beth M. Beadle, Gary B. Gunn, David Schwartz, Merill S. Kies, Randal S. Weber, K. Kian Ang, David I. Rosenthal

Research output: Contribution to journalArticle

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Abstract

Purpose: To report mature results of a large cohort of patients diagnosed with squamous cell carcinoma of the oropharynx who were treated with intensity modulated radiation therapy (IMRT). Methods and Materials: The database of patients irradiated at The University of Texas, M.D. Anderson Cancer Center was searched for patients diagnosed with oropharyngeal cancer and treated with IMRT between 2000 and 2007. A retrospective review of outcome data was performed. Results: The cohort consisted of 776 patients. One hundred fifty-nine patients (21%) were current smokers, 279 (36%) former smokers, and 337 (43%) never smokers. T and N categories and American Joint Committee on Cancer group stages were distributed as follows: T1/x, 288 (37%); T2, 288 (37%); T3, 113 (15%); T4, 87 (11%); N0, 88(12%); N1/x, 140 (18%); N2a, 101 (13%); N2b, 269 (35%); N2c, 122 (16%); and N3, 56 (7%); stage I, 18(2%); stage II, 40(5%); stage III, 150(19%); and stage IV, 568(74%). Seventy-one patients (10%) presented with nodes in level IV. Median follow-up was 54 months. The 5-year overall survival, locoregional control, and overall recurrence-free survival rates were 84%, 90%, and 82%, respectively. Primary site recurrence developed in 7% of patients, and neck recurrence with primary site control in 3%. We could only identify 12 patients (2%) who had locoregional recurrence outside the high-dose target volumes. Poorer survival rates were observed in current smokers, patients with larger primary (T) tumors and lower neck disease. Conclusions: Patients with oropharyngeal cancer treated with IMRT have excellent disease control. Locoregional recurrence was uncommon, and most often occurred in the high dose volumes. Parotid sparing was accomplished in nearly all patients without compromising tumor coverage.

Original languageEnglish (US)
Pages (from-to)941-947
Number of pages7
JournalInternational Journal of Radiation Oncology Biology Physics
Volume85
Issue number4
DOIs
StatePublished - Mar 15 2013
Externally publishedYes

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Oropharyngeal Neoplasms
radiation therapy
Radiotherapy
cancer
Recurrence
Therapeutics
Neoplasms
Neck
tumors
Survival Rate
dosage
Oropharynx
Squamous Cell Carcinoma

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation
  • Cancer Research

Cite this

Patterns of disease recurrence following treatment of oropharyngeal cancer with intensity modulated radiation therapy. / Garden, Adam S.; Dong, Lei; Morrison, William H.; Stugis, Erich M.; Glisson, Bonnie S.; Frank, Steven J.; Beadle, Beth M.; Gunn, Gary B.; Schwartz, David; Kies, Merill S.; Weber, Randal S.; Ang, K. Kian; Rosenthal, David I.

In: International Journal of Radiation Oncology Biology Physics, Vol. 85, No. 4, 15.03.2013, p. 941-947.

Research output: Contribution to journalArticle

Garden, AS, Dong, L, Morrison, WH, Stugis, EM, Glisson, BS, Frank, SJ, Beadle, BM, Gunn, GB, Schwartz, D, Kies, MS, Weber, RS, Ang, KK & Rosenthal, DI 2013, 'Patterns of disease recurrence following treatment of oropharyngeal cancer with intensity modulated radiation therapy', International Journal of Radiation Oncology Biology Physics, vol. 85, no. 4, pp. 941-947. https://doi.org/10.1016/j.ijrobp.2012.08.004
Garden, Adam S. ; Dong, Lei ; Morrison, William H. ; Stugis, Erich M. ; Glisson, Bonnie S. ; Frank, Steven J. ; Beadle, Beth M. ; Gunn, Gary B. ; Schwartz, David ; Kies, Merill S. ; Weber, Randal S. ; Ang, K. Kian ; Rosenthal, David I. / Patterns of disease recurrence following treatment of oropharyngeal cancer with intensity modulated radiation therapy. In: International Journal of Radiation Oncology Biology Physics. 2013 ; Vol. 85, No. 4. pp. 941-947.
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abstract = "Purpose: To report mature results of a large cohort of patients diagnosed with squamous cell carcinoma of the oropharynx who were treated with intensity modulated radiation therapy (IMRT). Methods and Materials: The database of patients irradiated at The University of Texas, M.D. Anderson Cancer Center was searched for patients diagnosed with oropharyngeal cancer and treated with IMRT between 2000 and 2007. A retrospective review of outcome data was performed. Results: The cohort consisted of 776 patients. One hundred fifty-nine patients (21{\%}) were current smokers, 279 (36{\%}) former smokers, and 337 (43{\%}) never smokers. T and N categories and American Joint Committee on Cancer group stages were distributed as follows: T1/x, 288 (37{\%}); T2, 288 (37{\%}); T3, 113 (15{\%}); T4, 87 (11{\%}); N0, 88(12{\%}); N1/x, 140 (18{\%}); N2a, 101 (13{\%}); N2b, 269 (35{\%}); N2c, 122 (16{\%}); and N3, 56 (7{\%}); stage I, 18(2{\%}); stage II, 40(5{\%}); stage III, 150(19{\%}); and stage IV, 568(74{\%}). Seventy-one patients (10{\%}) presented with nodes in level IV. Median follow-up was 54 months. The 5-year overall survival, locoregional control, and overall recurrence-free survival rates were 84{\%}, 90{\%}, and 82{\%}, respectively. Primary site recurrence developed in 7{\%} of patients, and neck recurrence with primary site control in 3{\%}. We could only identify 12 patients (2{\%}) who had locoregional recurrence outside the high-dose target volumes. Poorer survival rates were observed in current smokers, patients with larger primary (T) tumors and lower neck disease. Conclusions: Patients with oropharyngeal cancer treated with IMRT have excellent disease control. Locoregional recurrence was uncommon, and most often occurred in the high dose volumes. Parotid sparing was accomplished in nearly all patients without compromising tumor coverage.",
author = "Garden, {Adam S.} and Lei Dong and Morrison, {William H.} and Stugis, {Erich M.} and Glisson, {Bonnie S.} and Frank, {Steven J.} and Beadle, {Beth M.} and Gunn, {Gary B.} and David Schwartz and Kies, {Merill S.} and Weber, {Randal S.} and Ang, {K. Kian} and Rosenthal, {David I.}",
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AU - Garden, Adam S.

AU - Dong, Lei

AU - Morrison, William H.

AU - Stugis, Erich M.

AU - Glisson, Bonnie S.

AU - Frank, Steven J.

AU - Beadle, Beth M.

AU - Gunn, Gary B.

AU - Schwartz, David

AU - Kies, Merill S.

AU - Weber, Randal S.

AU - Ang, K. Kian

AU - Rosenthal, David I.

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N2 - Purpose: To report mature results of a large cohort of patients diagnosed with squamous cell carcinoma of the oropharynx who were treated with intensity modulated radiation therapy (IMRT). Methods and Materials: The database of patients irradiated at The University of Texas, M.D. Anderson Cancer Center was searched for patients diagnosed with oropharyngeal cancer and treated with IMRT between 2000 and 2007. A retrospective review of outcome data was performed. Results: The cohort consisted of 776 patients. One hundred fifty-nine patients (21%) were current smokers, 279 (36%) former smokers, and 337 (43%) never smokers. T and N categories and American Joint Committee on Cancer group stages were distributed as follows: T1/x, 288 (37%); T2, 288 (37%); T3, 113 (15%); T4, 87 (11%); N0, 88(12%); N1/x, 140 (18%); N2a, 101 (13%); N2b, 269 (35%); N2c, 122 (16%); and N3, 56 (7%); stage I, 18(2%); stage II, 40(5%); stage III, 150(19%); and stage IV, 568(74%). Seventy-one patients (10%) presented with nodes in level IV. Median follow-up was 54 months. The 5-year overall survival, locoregional control, and overall recurrence-free survival rates were 84%, 90%, and 82%, respectively. Primary site recurrence developed in 7% of patients, and neck recurrence with primary site control in 3%. We could only identify 12 patients (2%) who had locoregional recurrence outside the high-dose target volumes. Poorer survival rates were observed in current smokers, patients with larger primary (T) tumors and lower neck disease. Conclusions: Patients with oropharyngeal cancer treated with IMRT have excellent disease control. Locoregional recurrence was uncommon, and most often occurred in the high dose volumes. Parotid sparing was accomplished in nearly all patients without compromising tumor coverage.

AB - Purpose: To report mature results of a large cohort of patients diagnosed with squamous cell carcinoma of the oropharynx who were treated with intensity modulated radiation therapy (IMRT). Methods and Materials: The database of patients irradiated at The University of Texas, M.D. Anderson Cancer Center was searched for patients diagnosed with oropharyngeal cancer and treated with IMRT between 2000 and 2007. A retrospective review of outcome data was performed. Results: The cohort consisted of 776 patients. One hundred fifty-nine patients (21%) were current smokers, 279 (36%) former smokers, and 337 (43%) never smokers. T and N categories and American Joint Committee on Cancer group stages were distributed as follows: T1/x, 288 (37%); T2, 288 (37%); T3, 113 (15%); T4, 87 (11%); N0, 88(12%); N1/x, 140 (18%); N2a, 101 (13%); N2b, 269 (35%); N2c, 122 (16%); and N3, 56 (7%); stage I, 18(2%); stage II, 40(5%); stage III, 150(19%); and stage IV, 568(74%). Seventy-one patients (10%) presented with nodes in level IV. Median follow-up was 54 months. The 5-year overall survival, locoregional control, and overall recurrence-free survival rates were 84%, 90%, and 82%, respectively. Primary site recurrence developed in 7% of patients, and neck recurrence with primary site control in 3%. We could only identify 12 patients (2%) who had locoregional recurrence outside the high-dose target volumes. Poorer survival rates were observed in current smokers, patients with larger primary (T) tumors and lower neck disease. Conclusions: Patients with oropharyngeal cancer treated with IMRT have excellent disease control. Locoregional recurrence was uncommon, and most often occurred in the high dose volumes. Parotid sparing was accomplished in nearly all patients without compromising tumor coverage.

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