Background: The aim of this retrospective study was to evaluate the therapeutic outcomes and organ preservation in patients with squamous cell carcinoma of the buccal mucosa treated with radiotherapy and retrograde superselective intra-arterial chemotherapy. Materials and Methods: Between April 2006 and March 2016, 28 patients (3 with stage II; 8 with stage III; and 17 with stage IV) with squamous cell carcinoma of the buccal mucosa were treated with definitive intra-arterial chemoradiotherapy. The median follow-up for all patients was 39months (range, 4-123months ). Catheterization of the tumor feeding arteries from the superficial temporal and/or occipital arteries was performed. Treatment consisted of radiotherapy (total 50-70 Gy) and daily concurrent superselective    intra-arterial chemotherapy (docetaxel, 50-70 mg/m2, cisplatin, total 125-175 mg/m2) for 5-7 weeks. Results: After intra-arterial chemoradiotherapy, primary site complete response was achieved in 25 (89.3%) of 28 cases. Three-year local control and overall survival rates were 82.1% and 85.4%, respectively. Grade 3 or 4 toxicities included mucositis in 96.4%, and dermatitis in 28.6% of patients. Grade 3 toxicities included dysphagia in 35.7%, neutropenia in 28.6%, anemia in 10.7%, and fever in 7.1% of patients. Conclusion: Retrograde superselective intra-arterial chemoradiotherapy for squamous cell carcinoma of the buccal mucosa provided good local control and overall survival.

Background: The optimal radiation dose for oral cavity cancers treated with retrograde superselective intra-arterial chemoradiotherapy (SIACRT) is unclear. The aim of the present study was to evaluate the treatment outcome and toxicity in patients treated with <60 Gy compared with those treated with ≥60 Gy to provide evidence for determining the optimal dose. Materials and Methods: Between January 2009 and December 2013, 159 oral cavity cancer patients were treated with SIACRT with curative intent at a single institution. One hundred and twenty-nine patients received ≥60 Gy and 30 received <60 Gy. Local control (LC), disease-free survival (DFS), overall survival (OS), and toxicity were compared. Propensity score matching was performed to reduce bias. Results: The median follow-up period was 48 months (range, 2–88 months). LC (<60 Gy vs. ≥60 Gy, 81.5% vs. 86.1% at 3 years, p = 0.534), DFS (68.8% vs. 72.4% at 3 years, p = 0.816), and OS (85.9% vs. 72.3% at 3 years, p = 0.132) were comparable between the two groups. There was also no difference in toxicity. However, the median overall treatment period was significantly shorter in the <60 Gy cohort (39 days vs. 49 days, p < 0.0001). Conclusion: The radiation dose may be reduced to <60 Gy when treating oral cavity cancers with SIACRT.

Background: To evaluate structural variation of the parotid gland in post-radiotherapy oral carcinoma patients. Material and Methods: 52 patients (33 males, 19 females) with histologically confirmed cancer of head and neck region were enrolled. All the patients underwent intensity modulated radiotherapy (IMRT) with linear accelerator. A quantitative analysis was conducted with the help of contrast enhanced computed tomography (CECT) scan regarding the changes in the volume and density of the parotid glands (PGs) along with the assessment of their interrelationship in relation to the mean dose applied to the glands. The evaluations were done immediately after radiotherapy, and after 2 and 3 years. Results: Parotid size reduction was observed in 77.77 % of cases immediately after radiotherapy with a mean dose of 26.66 Gy applied to the parotid glands. Parotid shrinkage reduced to 61.5 % cases three years post radiotherapy. High density changes were revealed by 69.2 % cases immediately after radiotherapy with a mean dose of 34.53 Gy applied to these parotid glands. Low density changes were revealed by 48.1 % cases after 2 years follow up which further reduced to 25 % at three years follow up. Conclusion: There was evidence of structural variation in the PGs during the course of IMRT which was significantly related with the mean dose applied to them. There were high density changes and low density changes immediately after radiotherapy and 2-3 years post-radiotherapy respectively. Further there was volumetric shrinkage post-radiotherapy which shows recovery 2 and 3 years post-radiotherapy.