Analysis of prognostic factors in patients with oropharyngeal squamous cell carcinoma treated with radiotherapy alone or in combination with systemic chemotherapy

Arch Otolaryngol Head Neck Surg. 2008 Nov;134(11):1196-204. doi: 10.1001/archotol.134.11.1196.


Objective: To assess the prognostic significance of several factors in oropharyngeal squamous cell carcinoma treated with radiotherapy alone or in combination with chemotherapy.

Design: Retrospective study.

Setting: Erasto Gaertner Hospital, Curitiba, Brazil, and A. C. Camargo Hospital, São Paulo, Brazil.

Patients: A total of 361 patients treated for squamous cell carcinoma from January 1, 1990, to December 31, 2001.

Interventions: Radiotherapy alone or with chemotherapy.

Main outcome measures: Disease-free survival, overall survival, and treatment response.

Results: Most tumors were located at the tonsil (46.8%) or base of the tongue (28.0%) and were at clinical stage III or IV (92.8%). Treatment response was associated with Zubrod scale score, weight loss, number of comorbidities, symptom-severity and Piccirillo stages, hemoglobin level, tumor site, macroscopic appearance of the tumor, and clinical stage. The 5-year overall survival rate was 17.6% and disease-free survival rate was 16.2%. The significant prognostic variables were age; Zubrod scale score; weight loss; comorbidities; Berg, Piccirillo, and symptom-severity staging; involvement of adjacent soft-tissue areas and bone; lymph node mobility; clinical stage; and radiotherapy doses. The multivariate analysis showed Zubrod scale score, symptom-severity staging system, Berg staging system, comorbidities, and radiotherapy dose as independent prognostic factors.

Conclusion: A combination of clinical factors, such as symptoms, patients' general status, weight loss, and comorbidities, leads to a relevant stage of clinical severity that can be associated with the TNM stage as predictors of survival in oropharyngeal carcinoma.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / radiotherapy*
  • Chemotherapy, Adjuvant
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / drug therapy*
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / radiotherapy*
  • Prognosis
  • Radiotherapy Dosage
  • Retrospective Studies
  • Tongue Neoplasms / drug therapy
  • Tongue Neoplasms / mortality
  • Tongue Neoplasms / pathology
  • Tongue Neoplasms / radiotherapy
  • Tonsillar Neoplasms / drug therapy
  • Tonsillar Neoplasms / mortality
  • Tonsillar Neoplasms / pathology
  • Tonsillar Neoplasms / radiotherapy