Long term effectiveness of intraoperative radiotherapy given as a boost in adjuvant treatment for oral cavity cancers

Abstract The oral cancer treatment of choice is surgical excision with an organ preservation, if it is possible. Radiation therapy is commonly used as a postoperative treatment. Delivering radiation dose during surgery, defined as intraoperative radiotherapy (IORT), can be very useful especially in...

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Main Authors: Grzegorz Woźniak, Tomasz Rutkowski, Wojciech Majewski, Aleksandra Napieralska, Jerzy Wydmański, Agnieszka Czarniecka, Cezary Szymczyk, Adam Bekman, Żaneta Kaniszewska Dorsz, Tomasz Latusek, Bogusław Maciejewski
Format: Article
Language:English
Published: Nature Portfolio 2025-02-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-87498-3
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author Grzegorz Woźniak
Tomasz Rutkowski
Wojciech Majewski
Aleksandra Napieralska
Jerzy Wydmański
Agnieszka Czarniecka
Cezary Szymczyk
Adam Bekman
Żaneta Kaniszewska Dorsz
Tomasz Latusek
Bogusław Maciejewski
author_facet Grzegorz Woźniak
Tomasz Rutkowski
Wojciech Majewski
Aleksandra Napieralska
Jerzy Wydmański
Agnieszka Czarniecka
Cezary Szymczyk
Adam Bekman
Żaneta Kaniszewska Dorsz
Tomasz Latusek
Bogusław Maciejewski
author_sort Grzegorz Woźniak
collection DOAJ
description Abstract The oral cancer treatment of choice is surgical excision with an organ preservation, if it is possible. Radiation therapy is commonly used as a postoperative treatment. Delivering radiation dose during surgery, defined as intraoperative radiotherapy (IORT), can be very useful especially in case of high risk of recurrence or where gross or macroscopic residual disease are present. The aim of this retrospective study is to evaluate the effectiveness of IORT combined with postoperative fractionated irradiation (EBRT) of patients with squamous cell carcinoma of the oral cavity. The study included 23 patients: IORT dose of 5–7.5 Gy was delivered using 50 kV X-rays generated by INTRABEAM™, combined with EBRT of 50–60 Gy in 25–30 fractions depending on presence of extracapsular invasion and narrow or positive surgical margins. Standard statistical tests were used. Median follow up was 64 months (range 8–222 months). The 5-year local tumour control was 92% and 82.5% in the 10-year follow-up. The 5-year overall survival (OS) was 56% and decreased to 45% during the next 5 years. There were no differences in the LTC, DFS and OS regarding sex, T-stage, grade and tumour localization, although a small group of analysed cases may raise some uncertainties. Acute side effects of combined IORT and EBRT were mild and no late complications occurred. The present study indicated that low-energy X-rays IORT combined with postoperative EBRT is a feasible and safe therapeutic modality which likely reduces a risk of locoregional recurrences.
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spelling doaj-art-3cd66dcd2774428e8b6a01f3eec822372025-02-09T12:29:01ZengNature PortfolioScientific Reports2045-23222025-02-011511910.1038/s41598-025-87498-3Long term effectiveness of intraoperative radiotherapy given as a boost in adjuvant treatment for oral cavity cancersGrzegorz Woźniak0Tomasz Rutkowski1Wojciech Majewski2Aleksandra Napieralska3Jerzy Wydmański4Agnieszka Czarniecka5Cezary Szymczyk6Adam Bekman7Żaneta Kaniszewska Dorsz8Tomasz Latusek9Bogusław Maciejewski10Radiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceRadiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceRadiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceRadiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceRadiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceOncologic and Reconstructive Surgery Clinic, Maria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceOncologic and Reconstructive Surgery Clinic, Maria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceMedical Physics Department, Maria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceRadiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceRadiotherapy Department, Maria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceMaria Sklodowska-Curie National Research Institute of Oncology, Branch GliwiceAbstract The oral cancer treatment of choice is surgical excision with an organ preservation, if it is possible. Radiation therapy is commonly used as a postoperative treatment. Delivering radiation dose during surgery, defined as intraoperative radiotherapy (IORT), can be very useful especially in case of high risk of recurrence or where gross or macroscopic residual disease are present. The aim of this retrospective study is to evaluate the effectiveness of IORT combined with postoperative fractionated irradiation (EBRT) of patients with squamous cell carcinoma of the oral cavity. The study included 23 patients: IORT dose of 5–7.5 Gy was delivered using 50 kV X-rays generated by INTRABEAM™, combined with EBRT of 50–60 Gy in 25–30 fractions depending on presence of extracapsular invasion and narrow or positive surgical margins. Standard statistical tests were used. Median follow up was 64 months (range 8–222 months). The 5-year local tumour control was 92% and 82.5% in the 10-year follow-up. The 5-year overall survival (OS) was 56% and decreased to 45% during the next 5 years. There were no differences in the LTC, DFS and OS regarding sex, T-stage, grade and tumour localization, although a small group of analysed cases may raise some uncertainties. Acute side effects of combined IORT and EBRT were mild and no late complications occurred. The present study indicated that low-energy X-rays IORT combined with postoperative EBRT is a feasible and safe therapeutic modality which likely reduces a risk of locoregional recurrences.https://doi.org/10.1038/s41598-025-87498-3Oral cavity cancerIORTEBRTLocal tumour controlOverall survival
spellingShingle Grzegorz Woźniak
Tomasz Rutkowski
Wojciech Majewski
Aleksandra Napieralska
Jerzy Wydmański
Agnieszka Czarniecka
Cezary Szymczyk
Adam Bekman
Żaneta Kaniszewska Dorsz
Tomasz Latusek
Bogusław Maciejewski
Long term effectiveness of intraoperative radiotherapy given as a boost in adjuvant treatment for oral cavity cancers
Scientific Reports
Oral cavity cancer
IORT
EBRT
Local tumour control
Overall survival
title Long term effectiveness of intraoperative radiotherapy given as a boost in adjuvant treatment for oral cavity cancers
title_full Long term effectiveness of intraoperative radiotherapy given as a boost in adjuvant treatment for oral cavity cancers
title_fullStr Long term effectiveness of intraoperative radiotherapy given as a boost in adjuvant treatment for oral cavity cancers
title_full_unstemmed Long term effectiveness of intraoperative radiotherapy given as a boost in adjuvant treatment for oral cavity cancers
title_short Long term effectiveness of intraoperative radiotherapy given as a boost in adjuvant treatment for oral cavity cancers
title_sort long term effectiveness of intraoperative radiotherapy given as a boost in adjuvant treatment for oral cavity cancers
topic Oral cavity cancer
IORT
EBRT
Local tumour control
Overall survival
url https://doi.org/10.1038/s41598-025-87498-3
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