Clinicopathological Analysis and Survival Outcomes of Radiation-Induced Oral Squamous Cell Carcinoma: A Systematic Review and Meta-Analysis.

BACKGROUND

Radiotherapy-induced malignancies are well-documented, but the clinicopathological profile and prognostic factors of radiation-induced oral squamous cell carcinoma (R-OSCC) remain unclear.

METHODS

The present review was conducted in accordance with the PRISMA guidelines and has been registered in the PROSPERO (registration number CRD42024560015). A comprehensive search was performed across electronic databases and gray literature sources. The risk of bias was assessed using the JBI tool. Meta-analysis was performed with Review Manager 5.4.

RESULTS

Five cohort studies were included (n = 310), with four pooled in a meta-analysis. R-OSCC was significantly associated with tongue tumors (p = 0.007) and early clinical stages (p < 0.0001). Negative perineural invasion was linked to sporadic OSCC (p = 0.0008). Smoking (p = 0.0008) and radiotherapy (RT) history (p < 0.00001) were associated with decreased overall survival (OS), while RT history also reduced disease-specific survival (DSS) in R-OSCC patients (p = 0.006).

CONCLUSIONS

R-OSCC predominantly affects the tongue, is diagnosed in early stages, and the history of RT is associated with reduced OS and DSS.