Patterns of locoregional failure following post-operative intensity-modulated radiotherapy to oral cavity cancer: quantitative spatial and dosimetric analysis using a deformable image registration workflow

Mohamed, Abdallah S. R.; Wong, Andrew J.; Fuller, Clifton D.; Kamal, Mona; Gunn, Gary B.; Phan, Jack; Morrison, William H.; Beadle, Beth M.; Skinner, Heath; Lai, Stephen Y.; Quinlan-Davidson, Sean R.; Belal, Abdelaziz M.; El-Gowily, Ahmed G.; Frank, Steven J.; Rosenthal, David I.; Garden, Adam S.

doi:10.1186/s13014-017-0868-y

Table 2 Failure Sites for non-type A Failures

From: Patterns of locoregional failure following post-operative intensity-modulated radiotherapy to oral cavity cancer: quantitative spatial and dosimetric analysis using a deformable image registration workflow

Patient	Local vs Regional	Predominant Failure Type	Primary Tumor Site	Pathologic TN Stage	Surgical margins	Neck dissection status and laterality	ECE	Neck Irradiation Laterality	DOI	PNI	LVI	Chemotherapy	CTV1 Dose (Gy/n. of Fracions)	Failure Site
1	L	B (peripheral high dose)	gingiva	T2 N0	-ve	-ve Ipsilat	-ve	Ipsilat	≤1.5 cm	+ve	-ve	No	60/30	Ipsilat RMT&Maxilla
2	L	B (peripheral high dose)	FOM	T1N2c	-ve	+ve Bilat	+ve	Bilat	>1.5 cm	-ve	-ve	No	13/6^b	FOM
3	L	C (central int. dose)	RMT	yT4ayN0	-ve	-ve Ipsilat	-ve	Bilat	≤1.5 cm	-ve	U/S	I + C	60/30	Ipsilat Masticator Space
4	L	C (central int. dose)	tongue	T4aN2b	-ve	+ve Bilat	-ve	Bilat	>1.5 cm	-ve	-ve	No	60/30	FOM
5	L	C (central int. dose)	FOM	T4aN1	-ve	+ve Bilat	-ve	Bilat	>1.5 cm	-ve	-ve	No	60/30	BOT
6	L	A^a	RMT	T4aN1	+ve	+ve Ipsilat	-ve	Ipsilat	>1.5 cm	+ve	-ve	No	70/33	Flap recurrence + Ipsilat Parotid & Masticator Space
7	L	D (peripheral int. dose)	gingiva	T4aN1	+ve	+ve Ipsilat	-ve	Bilat	≤1.5 cm	+ve	+ve	No	63/30	Ipsilat Masticator Space
8	L	E (extraneous)	FOM	T1 N1	-ve	+ve Bilat	-ve	Bilat	≤1.5 cm	+ve	+ve	No	60/30	Mandibular gingiva
9	L	E (extraneous)	gingiva	T4aN1	-ve	+ve Ipsilat	-ve	Ipsilat	≤1.5 cm	-ve	-ve	No	60/30	Contralat mandibular gingiva
10	L	E (extraneous)	gingiva	T4aN2b	close	+ve Ipsilat	-ve	Ipsilat	≤1.5 cm	+ve	-ve	C	60/30	Ipsilat masticator space
11	L	E (extraneous)	Buccal	yT2yN0	-ve	-ve Ipsilat	-ve	Ipsilat	>1.5 cm	-ve	-ve	I + C	60/30	Ipsilat perineural spread along V2&V3
12	LR	C (central int. dose)	tongue	T1 N1	-ve	+ve Ipsilat	+ve	Bilat	≤1.5 cm	-ve	-ve	C	60/30	FOM&Contralat level IIa
13	LR	C (central low dose)	tongue	T2 N0	-ve	-ve Ipsilat	-ve	Bilat	≤1.5 cm	-ve	+ve	C	64/30	Contralat tongue&level II
14	R	C (central low dose)	Hard palate	T3 N0	-ve	-ve Ipsilat	-ve	Bilat	≤1.5 cm	-ve	-ve	No	60/30	Contralat level IIa
15	R	C (central low dose)	gingiva	T4aNx	-ve	No dissection	N/A	Ipsilat	≤1.5 cm	-ve	-ve	No	64/32	Ipsilat level Ib
16	R	C (central int. dose)	RMT	T2 N1	-ve	+ve Ipsilat	-ve	Ipsilat	≤1.5 cm	-ve	-ve	No	60/30	Ipsilat level Ib
17	R	C (central low dose)	tongue	T2 N1	-ve	+ve Ipsilat	-ve	Bilat	≤1.5 cm	-ve	-ve	No	60/30	Contralat level Ib
18	R	C (central int. dose)	tongue	T1 N1	-ve	+ve Ipsilat	-ve	Bilat	≤1.5 cm	-ve	-ve	No	56/28	Level Ia
19	R	A^a	tongue	T3N2b	-ve	+ve Ipsilat	+ve	Bilat	>1.5 cm	+ve	+ve	C	60/30	Ipsilat level III (A) Contralat level IIa (C)
20	R	A^a	RMT	T4aN2b	close	+ve Ipsilat	-ve	Bilat	≤1.5 cm	-ve	U/S	C	60/30	Ipsilat level IIb (A) Ipsilat retropharyngeal node (D)
21	R	E (extraneous)	Buccal	yT3yN0	close	-ve Ipsilat	-ve	Ipsilat	≤1.5 cm	+ve	-ve	I	60/30	Contralat Pterygoid plates& maxilla
22	R	E (extraneous)	Buccal	T2N2b	close	+ve Ipsilat	-ve	Ipsilat	≤1.5 cm	-ve	+ve	No	60/30	Ipsilat parotid node
23	R	E (extraneous)	Buccal	T2N2b	-ve	+ve Ipsilat	+ve	Ipsilat	≤1.5 cm	-ve	-ve	C	60/30	Ipsilat parotid node
24	R	E (extraneous)	Buccal	T1N2b	close	+ve Ipsilat	+ve	Ipsilat	U/S	-ve	U/S	C	63/30	Contralat levels II, III, IV
25	R	E (extraneous)	gingiva	T2Nx	+ve	No dissection	N/A	Ipsilat	≤1.5 cm	-ve	U/S	No	65/30	Contralat level II
26	R	G (low neck)	tongue	T1N2b	-ve	+ve Ipsilat	-ve	Bilat	≤1.5 cm	+ve	+ve	No	60/30	contralat levels III, IV
27	R	G (low neck)	gingiva	yT4ayN0	close	-ve Ipsilat	-ve	Ipsilat	>1.5 cm	+ve	U/S	I	60/30	Ipsilat level VIb

^aIndicates type A failure with multifocal recurrence that includes non-type A lesions as well. ^bThis patient had received only 6 fractions and failed to appear for the remainder of her treatments. Abbreviations. ECE extracapsular extension, DOI depth of invasion, PNI perineural invasion, LVI lymphovascular invasion, L local, R regional, LR locoregional, FOM floor of mouth, RMT retromolar trigone, −ve negative, +ve positive, Ipsilat ipsilateral, Contralat contralateral, Bilat bilateral, U/S unspecified, I induction chemotherapy, C concurrent chemotherapy, I + C induction followed by concurrent chemotherapy, No no chemotherapy

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