Babu Geethu, Ravikumar Rejnish, Rafi Malu, Sharafuddin Zuzaki, Shankar S Arun, George Preethi Sara, Kainickal Cessal Thommachan, Kunnambath Ramadas
Department of Radiation Oncology, Regional Cancer Centre, Trivandrum, Kerala, India.
Department of Cancer Epidemiology and Biostatistics, Regional Cancer Centre, Trivandrum, Kerala, India.
Singapore Med J. 2025 Jul 1;66(7):368-372. doi: 10.4103/singaporemedj.SMJ-2021-282. Epub 2023 Aug 17.
Oral cancer is a major public health concern in India. Both conventional and altered fractionation radiotherapy schedules have been used in curative treatment of oral cancer. This study aimed to retrospectively evaluate the clinical profile and treatment outcomes of patients with carcinoma buccal mucosa who underwent treatment with definitive hypofractionated accelerated radiotherapy.
A total of 517 patients treated from January 2011 to December 2016 were eligible for the analysis. All patients were treated with definitive hypofractionated accelerated radiotherapy schedule of 5,250 cGy in 15 fractions over 3 weeks. Survival estimates were generated using the Kaplan-Meier method.
At a median follow-up of 77.4 months, 473 (91.5%) patients attained complete remission with radiation therapy. The 5-year disease-free survival (DFS) and overall survival (OS) rates were 69% and 80.5%, respectively. The 5-year OS for stage I, II, III and IVa tumours was 80.3%, 84.4%, 81.4% and 73.7%, respectively, and the DFS was 75.7%, 73.2%, 69.6% and 60.2%, respectively. Age >50 years was found to be a significant factor affecting DFS ( P = 0.026) and OS ( P = 0.048) in multivariate analysis. Fifty-three (10.3%) patients developed osteoradionecrosis of the mandible.
Excellent outcome could be achieved in less-aggressive, low-volume carcinoma of the buccal mucosa with radical accelerated hypofractionated radiotherapy. A radiotherapy schedule over a 3-week period is useful in high-volume centres.
口腔癌是印度主要的公共卫生问题。传统分割放疗方案和改变分割放疗方案均已用于口腔癌的根治性治疗。本研究旨在回顾性评估接受根治性大分割加速放疗的颊黏膜癌患者的临床特征和治疗结果。
共有2011年1月至2016年12月期间接受治疗的517例患者符合分析条件。所有患者均接受了3周内分15次给予5250 cGy的根治性大分割加速放疗方案。采用Kaplan-Meier法进行生存估计。
中位随访77.4个月时，473例（91.5%）患者放疗后达到完全缓解。5年无病生存率（DFS）和总生存率（OS）分别为69%和80.5%。I期、II期、III期和IVa期肿瘤的5年OS分别为80.3%、84.4%、81.4%和73.7%，DFS分别为75.7%、73.2%、69.6%和60.2%。多因素分析发现年龄>50岁是影响DFS（P = 0.026）和OS（P = 0.048）的重要因素。53例（10.3%）患者发生下颌骨放射性骨坏死。
对于侵袭性较小、体积较小的颊黏膜癌，采用根治性加速大分割放疗可取得良好疗效。3周的放疗方案在大型中心是有用的。
