Does frequent follow-up after radical treatment of oropharyngeal cancer improve outcomes?

A. Sundaramurthy, K.L. MacLennan, I. Fragkandrea-Nixon

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Radiation therapy (RT) remains the standard treatment for oropharyngeal cancers (OPC) both in terms of survival as well as functional outcome. The highest risk of recurrence is within the first 2 years, and hence the rationale for very close follow-up. We aim to report on our patients who relapsed following radical radiation-based treatment and intend to find whether a close follow-up improves survival.
We looked at an unselected group of 142 patients treated with either concurrent chemoradiation therapy (CRT) or radiation therapy alone (RT) for OPC at Edinburgh Cancer Centre (ECC) during January 2006 to December 2010. Relapsed patients in this cohort were identified and analyzed.
There were a total of 13 relapses, of whom 6 were local and 7 had distant disease. Nine patients had CRT, while 4 had RT. All but 1 patient had locally advanced disease. Neoadjuvant chemotherapy (NAC) was used in only 1 of the patients. The median time to relapse was 10.6 months (range, 8.1-16.8). In this cohort, 5 patients either never smoked or were ex-smokers, and 8 were current smokers. The current smokers had an early relapse duration with a median of 8.0 months (range, 7.5-25) compared those who never smoked or ex-smokers (median time to relapse 13.1 months; range, 8.5-50.5). The median RT duration was 45 days, with 9 out of 13 patients completing radiation within 46 days. Patients who completed radiation within 46 days had a longer median time to relapse compared the group who took longer (10.6 months vs 8.5 months, χ2 0.7436, P=.38). One out of 6 local relapsed patients was eligible for salvage surgery and lived for 9.5 months after surgery. The median survival for all patients from diagnosis of relapse was 3.7 months (95% confidence interval, 1.1-7.7).
Though the low numbers preclude a significant statistical analysis, the trends suggest early relapse in smokers and those who had prolonged radiation therapy duration. All the relapses happened within the first 2 years of treatment. Though a very close follow-up of 142 patients resulted in a longer survival for the 1 patient who had salvage surgery, the impact of best supportive measures the other relapsed patients benefitted from could not be measured from these data. Hence, we recommend continuing the current practice of close follow-up as well as further widening the number of patients to make robust decisions.
Original languageEnglish
Article numberP969
Number of pages1
JournalInternational Journal of Radiation Oncology*Biology*Physics
Issue number4
Publication statusPublished - 15 Mar 2016


  • oropharyngeal cancers
  • radical treatments
  • radiation therapy (RT)


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