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European Journal of Oral and Maxillofacial Surgery 2021 December;5(3):105-9

DOI: 10.23736/S2532-3466.21.00252-6


language: English

Time of commencing postoperative adjuvant radiotherapy may not be an adverse determinant of recurrences in oral cancer patients treated with close surgical margins

Hareendra JINADASA 1, Nadeena S. JAYASURIYA 1, Irosha R. PERERA 2, Kemiya H. KODITUWAKKU 1, Senaka KANDEGEDARA 3, Navini T. MANNAPPERUMA 1, Priyan K. COORAY 1 , Sakuntha RATNAPREYA 4, Kanchana KAPUGAMA 1, Manjula ATTYGALLA 1

1 Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Peradeniya, Sri Lanka; 2 Unit of Preventive Oral Health, National Dental Hospital, Colombo, Sri Lanka; 3 Unit of Clinical Oncology, National Hospital of Sri Lanka, Kandy, Sri Lanka; 4 Department of Dental Surgery, Asiri Surgical Hospital, Colombo, Sri Lanka

BACKGROUND: Close surgical margin is a high-risk factor for recurrences. Therefore, adjuvant postoperative radiotherapy (PORT) should be started as soon as possible. Due to patient or health care related factors, time of initiating PORT can change. This pilot study aimed to assess the influence of timing of PORT on local recurrences.
METHODS: Patients with oral squamous cell carcinoma (OSCC) who had close excision margins (Group A) and patients with clear excision margins (Group B) were studied from 2015 to 2019. The ideal time to start radiotherapy was recorded as within 6 weeks and a recurrence as a lesion within 2 cm from the primary. Data was analyzed using SPSS-21 Statistical Package. Descriptive statistics, Fisher’s Exact test for group comparisons were used for statistical analysis. P value <0.05 was considered as the cut-off point of statistical significance.
RESULTS: Groups A and B included 22 patients each. Six months survival of the two groups were 72.7% and 86.4% with a local recurrence rate of 45.4% and 22.7% respectively. In group A, only 40% of patient initiated PORT within 6 weeks. Patients who started PORT before 6 weeks had a slightly lower recurrence rate compared to those who started after 6 weeks (37.5% vs. 50%). However, the difference in recurrence rate or survival were not statistically significant (P>0.05).
CONCLUSIONS: Initiating PORT early did not demonstrate significant benefit over local recurrences. Therefore, the current practice may continue while a larger sample should be studied with a longer follow-up period.

KEY WORDS: Squamous cell carcinoma of head and neck; Radiotherapy; Neoplasm recurrence, local; Sri Lanka

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