Missed radiation therapy sessions in first three weeks predict distant metastasis and less favorable outcomes in surgically treated patients with oral cavity squamous cell carcinoma

Background We sought to investigate the prognostic impact of missed RT sessions in patients who had undergone surgery for oral cavity squamous cell carcinoma (OCSCC). Methods The study sample consisted of 905 patients with surgically treated OCSCC who fulfilled criteria of RT course [less than or eq...

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Published in:Radiation oncology (London, England) England), 2020-08, Vol.15 (1), p.1-9, Article 194
Main Authors: Chiang, Yin-Yin, Chou, Yung-Chih, Chang, Kai-Ping, Liao, Chun-Ta, Wu, Yao-Yu, Yap, Wing-Keen, Pai, Ping-Ching, Chang, Joseph Tung-Chieh, Lin, Chien-Yu, Fan, Kang-Hsing, Huang, Bing-Shen, Hung, Tsung-Min, Tsang, Ngan-Ming
Format: Article
Language:English
Subjects:
Care and treatment
Chemotherapy
Confidence intervals
Development and progression
Dissection
Distant metastasis
Medical prognosis
Metastases
Metastasis
Methods
Missed sessions
Mouth cancer
Multivariate analysis
Oral cancer
Oral cavity
Oral cavity cancer
Overall survival
Patient outcomes
Radiation
Radiation therapy
Radiotherapy
Schedules
Smoking
Spinal cord
Squamous cell carcinoma
Surgery
Tumors
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Summary:Background We sought to investigate the prognostic impact of missed RT sessions in patients who had undergone surgery for oral cavity squamous cell carcinoma (OCSCC). Methods The study sample consisted of 905 patients with surgically treated OCSCC who fulfilled criteria of RT course [less than or equai to]8 weeks. The study participants were divided into three groups based on the characteristics of missed RT, as follows: 1) early missed RT, 2) late missed RT, and 3) RT as scheduled. Results The 5-year overall survival (OS) rates in the early missed RT, late missed RT, and RT as scheduled groups were 53.0, 58.1, and 64.5%, respectively (p = 0.046). In multivariate analysis, early missed RT was independently associated with both OS (hazard ratio (HR) = 1.486; 95% confidence interval (CI): 1.122-1.966; p = 0.006) and the occurrence of distant metastasis (HR = 1.644; 95% CI: 1.047-2.583; p = 0.031). Conclusion Early missed RT was independently associated with a higher occurrence of distant metastasis and less favorable OS in patients who had undergone surgery for OCSCC. Keywords: Oral cavity cancer, Squamous cell carcinoma, Radiation therapy, Missed sessions, Overall survival, Distant metastasis, Prognosis
ISSN:1748-717X
1748-717X
DOI:10.1186/s13014-020-01632-1