Survival Following Non Surgical Treatments for Oral Cancer: a Single Institutional Result

  • Larizadeh, Mohammad Hasan (Department of Radiation Oncology, Kerman Neuroscience Research Center, Kerman University of Medical Sciences) ;
  • Shabani, Mohammad (Department of Neurophysiology, Kerman Neuroscience Research Center, Kerman University of Medical Sciences)
  • Published : 2012.08.31


Aim: To report the results of radiotherapy with or without chemotherapy in the patients with oral cancer. Methods: Over the 2003-2009 periods, a total number of 69 patients with squamous cell carcinoma of the oral cavity that refused surgery or had unresectable tumor were enrolled in this study. A total dose of 60 to 70 Gy (2 Gy per day) was given to the primary tumor and clinically positive nodes. In the patients with locoregionally advanced disease (57 patients with $T_3$, $T_4$ lesions and/ or $N^+$) induction chemotherapy following by concomitant chemoradiation was used. Induction chemotherapy consisted of 3 cycles of Cisplatin and 5-Flourouracil with or without Docetaxel. Weekly cisplatin was used in concomitant protocol. Kaplan-Meier method was used to calculate overall survival. Log-rank test and Cox regression model were used for comparison purposes. Results: Median follow-up was 32 months. The mean age of the patients was 59.2 years. The overall response rate after induction chemotherapy was 68.4%. Actuarial overall survival rates after 2 and 3 years were 38% and 26%, respectively. Clinical stage emerged as the only independent predictor of survival. Conclusion: Outcome of the patients with oral cancer is poor. Presenting with an advanced stage lesion contributed to this result. The role of chemotherapy in advanced cases remains to be defined.


  1. Adelstein D J (2008). Redefining the role of induction chemotherapy in head and neck cancer. J Clinical Oncol, 26, 3117-9.
  2. Bell R B, Kademani D, Homer L, et al (2007). Tongue cancer: Is there a difference in survival compared with other subsites in the oral cavity? J Oral and Maxillofacial Surg, 65, 229-36.
  3. Brandizzi D, Gandolfo M, Velazco M L, et al (2008). Clinical features and evolution of oral cancer: A study of 274 cases in Buenos Aires, Argentina. Age (in years), 40, 9.
  4. Chandu A, Adams G, Smith A (2005). Factors affecting survival in patients with oral cancer: an Australian perspective. Int J Oral and Maxillofacial Surg, 34, 514-20.
  5. Effiom O A, Adeyemo W L, Omitola O G, et al (2008). Oral squamous cell carcinoma: a clinicopathologic review of 233 cases in Lagos, Nigeria. J Oral and Maxillofacial Surg, 66, 1595-9.
  6. Forastiere A A, Goepfert H, Maor M, et al (2003). Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. New England J Med, 349, 2091-8.
  7. Genden E M, Ferlito A, Silver C E, et al (????). Contemporary management of cancer of the oral cavity. Eur Archives of Oto-Rhino-Laryngology, 267, 1001-17.
  8. Langdon J D, Harvey P W, Rapidis A D, et al (1977). Oral cancer: The behaviour and response to treatment of 194 cases*. J Maxillofacial Surg, 5, 221-37.
  9. Larizadeh M H, Damghani M A (????). Sequential chemoradiotherapy in advanced laryngeal cancer: An institutional experience. Asian Pac J Clinical Oncol, 6, 106-10.
  10. Larsen S R, Johansen J, SA rensen J A, et al (2009). The prognostic significance of histological features in oral squamous cell carcinoma. J Oral Pathol & Med, 38, 657-62.
  11. Lee K, Veness M, Pearla Larson T, Morgan G (2005). Role of combined modality treatment of buccal mucosa squamous cell carcinoma. Australian Dental J, 50, 108-13.
  12. Montoro J R M C, Hicz H A, Souza L, et al (2008). Prognostic factors in squamous cell carcinoma of the oral cavity. Revista Brasileira de Otorrinolaringologia, 74, 861-6.
  13. Multidiciplinary A O F (2008). Oral cancer: the current status and strategies of its management. Chinese Med J, 121, 1859-60.
  14. Murthy V, Agarwal J, Laskar S G, et al (????). Analysis of prognostic factors in 1180 patients with oral cavity primary cancer treated with definitive or adjuvant radiotherapy. J Cancer Res and Therapeutics, 6, 282.
  15. Oliveira L R, Ribeiro-Silva A, Costa J P O, et al (2008). Prognostic factors and survival analysis in a sample of oral squamous cell carcinoma patients. Oral Radiol & Endodontol, 106, 685-95.
  16. Pointreau Y, Garaud P, Chapet S, et al (2009). Randomized trial of induction chemotherapy with cisplatin and 5-fluorouracil with or without docetaxel for larynx preservation. J National Cancer Institute, 101, 498-506.
  17. Posner M (2007). Evolving strategies for combined-modality therapy for locally advanced head and neck cancer. The Oncologist, 12, 967-74.
  18. Posner M R, Hershock D M, Blajman C R, et al (2007). Cisplatin and fluorouracil alone or with docetaxel in head and neck cancer. New England J Med, 357, 1705-15.
  19. Razak A A, Saddki N, Naing N N (????). Oral cancer survival among Malay patients in Hospital Universiti Sains Malaysia, Kelantan. Asian Pac J Cancer Prev, 11, 187-91.
  20. Rogers S N, Brown J S, Woolgar J A, et al (2009). Survival following primary surgery for oral cancer. Oral oncology, 45, 201-11.
  21. Shah J P, Gil Z (2009). Current concepts in management of oral cancer-surgery. Oral oncology, 45, 394-401.
  22. Vermorken J B, Remenar E, van Herpen C, et al (2007). Cisplatin, fluorouracil, and docetaxel in unresectable head and neck cancer. New England J Med, 357, 1695-704.
  23. Warnakulasuriya S, Mak V, Maller H (2007). Oral cancer survival in young people in South East England. Oral Oncology, 43, 982-6.
  24. Woolgar J, Rogers S, West C, et al (1999). Survival and patterns of recurrence in 200 oral cancer patients treated by radical surgery and neck dissection. Oral oncology, 35, 257-65.
  25. Woolgar J A, Scott J, Vaughan E, et al(1995). Survival, metastasis and recurrence of oral cancer in relation to pathological features. Annals of the Royal College of Surgeons of England, 77, 325.
  26. Yeole B B, Ramanakumar A V, Sankaranarayanan R (2003). Survival from oral cancer in Mumbai (Bombay), India. Cancer Causes and Control, 14, 945-52.

Cited by

  1. Preliminary Study of the GSTM1 Null Polymorphism and History of Tobacco Smoking among Oral Cancer Patients in Northeastern Thailand vol.17, pp.2, 2016,