Definitive intensity-modulated radiotherapy or surgery for early oral cavity squamous cell carcinoma: Propensity-score-matched, nationwide, population-based cohort study

Wen-Chi Liu; Hsueh-Erh Liu; Yi-Wei Kao; Lei Qin; Kuan-Chou Lin; Chih-Yuan Fang; Lo-Lin Tsai; Ben-Chang Shia; Szu-Yuan Wu

doi:10.1002/hed.26575

Definitive intensity-modulated radiotherapy or surgery for early oral cavity squamous cell carcinoma: Propensity-score-matched, nationwide, population-based cohort study

Head Neck. 2021 Apr;43(4):1142-1152. doi: 10.1002/hed.26575. Epub 2020 Dec 12.

Authors

Wen-Chi Liu^{1

2}, Hsueh-Erh Liu^{1

3

4}, Yi-Wei Kao⁵, Lei Qin⁶, Kuan-Chou Lin^{7

8}, Chih-Yuan Fang^{7

8}, Lo-Lin Tsai^{7

8}, Ben-Chang Shia⁵, Szu-Yuan Wu^{5

9

10

11

12

13}

Affiliations

¹ Graduate Institute of Clinical Medical Science, College of Medicine, Chang Gang University, Taoyuan, Taiwan.
² Telehealth Telecare Center, Taipei Medical University Hospital, Taipei, Taiwan.
³ Department of Rheumatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
⁴ Department of Nursing, College of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
⁵ Graduate Institute of Business Administration, Fu Jen Catholic University, Taipei, Taiwan.
⁶ School of Statistics, University of International Business and Economics, Beijing, China.
⁷ Division of Oral and Maxillofacial Surgery, Department of Dentistry, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁸ School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, Taiwan.
⁹ Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
¹⁰ Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
¹¹ Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.
¹² Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
¹³ Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan, Taiwan.

PMID: 33314548
DOI: 10.1002/hed.26575

Abstract

Background: No evidence is currently available to estimate the outcomes of intensity-modulated radiation therapy (IMRT) and surgery for patients with early oral cavity squamous cell carcinoma (E-OCSCC).

Methods: We recruited patients from the Taiwan Cancer Registry Database who had received a diagnosis of E-OCSCC. Propensity score matching was performed, and Cox proportional hazards model was used to analyze all-cause mortality.

Results: In the multivariate Cox regression analyses, the adjusted hazard ratio (aHR) (95% confidence interval [CI]) for surgery compared with definitive IMRT, T2N0M0 compared with T1N0M0, and male patients compared with female patients were 0.303 (0.245, 0.375), 1.340 (1.077, 1.668), and 2.012 (1.432, 2.826), respectively. The aHRs (95% CIs) for age 61 to 70, 71 to 80, and ≧81 years compared with <40 years were 2.984 (1.43, 4.225), 3.353 (2.578, 4.112), and 4.277 (4.104, 5.679), respectively.

Conclusions: For patients with E-OCSCC, surgery may be considered the first option rather than definitive IMRT.

Keywords: early stage; intensity-modulated radiation therapy; oral cavity squamous cell carcinoma; surgery; survival.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Aged
Cohort Studies
Female
Head and Neck Neoplasms*
Humans
Male
Middle Aged
Neoplasm Staging
Propensity Score
Proportional Hazards Models
Radiotherapy, Intensity-Modulated*
Retrospective Studies
Squamous Cell Carcinoma of Head and Neck / radiotherapy
Squamous Cell Carcinoma of Head and Neck / surgery
Taiwan / epidemiology