Treatment Results of Postoperative Radiotherapy on Squamous Cell Carcinoma of the Oral Cavity: Coexistence of Multiple Minor Risk Factors Results in Higher Recurrence Rates

Squamous cell carcinoma is the summits malignant neoplasm of the oral cavity. Tobacco and alcohol is identified as risk factors, but squamous cell carcinoma can occur in patients with no known risk factors. Oral cancer is the sixth most common malignancy and is one of the major causes of cancer morbidity and mortality worldwide. Cancer is caused due to a series of alteration in genetic and epigenetic factors that occur in multiple steps and is influenced by the genetic predisposition of the individual and by exogenous environmental factors. These factors result in a series of molecular alteration, including inactivation of tumor suppressor genes expression of p16 has been proposed as a marker for malignant transformation. The p16 staining was correlated between the control and study groups and p 16 was shown to be increasing expressed in premalignant and less expressed in malignant category and was found to be statistically significant by Fischer’s exact test. This study concluded that p16 was increasingly expressed in premalignant lesions and less expressed in malignant lesion. In the present study 9 of the control cases were p16 negative and one case showed sporadic staining. The study group I showed 1 case of sporadic staining, 6 cases of focal staining and 8 cases of diffuse staining. The study II showed 14 cases of sporadic staining, 6 cases of focal staining and 5 cases of diffuse staining. Hence variations cannot be accurately assessed, but it plays a crucial role in assessing pre-malignant lesions progressing to malignancy. To confirm this, a larger sample study is required. As advances in research have leads to greater understanding of potentially malignant lesions in the oral cavity.

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Use of small pelvic field instead of whole pelvic field in postoperative radiotherapy for node-negative, high-risk stages I and II cervical squamous cell carcinoma

International Journal of Gynecological Cancer ◽

10.1136/ijgc-00009577-200303000-00012 ◽

2003 ◽

Vol 13 (2) ◽

pp. 170-176 ◽

Cited By ~ 1

Author(s):

K. Ohara ◽

H. Tsunoda ◽

M. Nishida ◽

S. Sugahara ◽

T. Hashimoto ◽

...

Keyword(s):

Risk Factors ◽

Squamous Cell Carcinoma ◽

High Risk ◽

Cell Carcinoma ◽

Squamous Cell ◽

Postoperative Radiotherapy ◽

Surgical Margin ◽

Cervical Squamous Cell Carcinoma ◽

Node Negative ◽

Group 5

We investigated whether a small pelvic (SP) field that covers primarily the pericervical regions in postoperative radiotherapy for cervical squamous cell carcinoma is adequate for a subgroup of node-negative patients. Of 84 patients with stage I–II disease treated with postoperative radiotherapy due to pathologic risk factors, 42 node-negative patients received SP-field radiotherapy, whereas remaining 42 node-positive patients were treated with a conventional whole pelvic (WP) field that also covered pelvic lymph nodes, both with 50.0–50.4 Gy/25–28 fractions. The pathologic risk factors included positive nodes, deep stromal invasion (≥2 /3 thickness), parametrial extension, and positive or close surgical margin. Recurrence was identified for 20 patients: three in the SP group and 17 in the WP group. Intrapelvic recurrence accounted for all three recurrences in the SP group and for four in the WP group; 5-year pelvic-control rate did not differ significantly between the SP (93%) and WP (90%) groups. Extrapelvic recurrence (n = 11) was identified exclusively in the WP group. Patterns of recurrence indicate that use of an SP field instead of a WP field may be adequate in postoperative radiotherapy for a subgroup of node-negative, high-risk patients.

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