Objective: To investigate the indication, location and dose of postoperative radiotherapy for primary intraosseous carcinoma (PIOC) of the jaws.
Methods: From October 1969 to November 2005, 13 patients with PIOC were treated at the Cancer Hospital of Chinese Academy of Medical Sciences. Forty six cases with complete clinical data were collected from 27 published reports. Twenty-seven of the 59 patients were treated with surgery plus postoperative radiotherapy, and 22 with surgery alone.
Results: All of the 13 cases in our series had advanced disease, and overall 1-, 2- and 3-year survival rats were 59.2%, 33.8% and 12.7% , respectively. For the reported 59 cases in literature, the overall 1-, 2- and 3-year survival rats were 78.4%, 53.9% and 34.0%, respectively. They were 84.3%, 57.2% and 43.6% for the patients treated by surgery plus postoperative radiotherapy, whereas they were 81.8%, 71.2% and 35.1% for the patients by surgery alone (P = 0.908). It seemed that surgery plus postoperative radiotherapy could not improve the survival of PIOC patients with involvement of adjacent soft-tissues or positive neck nodes or partial excision of primary tumor when compared with surgery alone, if the bias of selection in the patients for postoperative radiotherapy was neglected.
Conclusion: Postopreative radiotherapy may improve the survival for the patient with primary intraosseous carcinoma of the jaws. Our suggestion is that postoperative radiotherapy should be applied to the patient with any of the following items: positive operative margin; tumor involvement of adjacent soft-tissues; positive neck nodes; partial excision of primary tumor. However, the location and dose of postoperative radiotherapy may be varying at different situation.