{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:35:31Z","timestamp":1786977331557,"version":"build-2736575974"},"reference-count":33,"publisher":"Wiley","issue":"15","license":[{"start":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T00:00:00Z","timestamp":1754956800000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Perineural invasion (PNI) in oral squamous cell carcinoma (OSCC) is linked to aggressive tumour behaviour and poorer survival outcomes. Adjuvant radiotherapy (RT) is recommended for PNI\u2010positive OSCC, but optimal RT target volume remains uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study retrospectively analysed 103 patients with histopathologically confirmed PNI\u2010positive OSCC treated between January 2017 and December 2023. All patients underwent surgery followed by adjuvant RT, with or without concurrent chemotherapy. Recurrence patterns were categorised as in\u2010field, marginal or out\u2010of\u2010field. Survival outcomes, including overall survival (OS) and disease\u2010free survival (DFS), were assessed using the Kaplan\u2013Meier method, and prognostic factors were analysed using univariate and multivariate models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median follow\u2010up was 22.2\u2009months. The 2\u2010year OS and DFS were 63% (95% CI: 53%\u201375%) and 57% (95% CI: 48%\u201368%), respectively. In\u2010field recurrences constituted 70% of local failures, with no recurrences observed at the skull base despite conservative RT volumes. Extensive PNI, large nerve involvement and extratumoral spread were significantly associated with higher recurrence rates and poorer survival. Multivariate analysis identified advanced tumour stage (T3\/T4) and extranodal extension (ENE) as independent predictors of worse OS (HR: 2.67,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.016; HR: 2.08,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045, respectively), while depth of invasion (DoI) &gt;\u200910\u2009mm significantly impacted DFS (HR: 0.28,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04 for DoI \u2264\u200910\u2009mm).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings suggest that expanding RT volumes to cover entire cranial nerve pathways may not improve outcomes and increase the risk of toxicity. A personalised approach to RT planning, incorporating PNI extent, nerve involvement and other high\u2010risk features, is essential for optimising treatment outcomes in PNI\u2010positive OSCC.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71134","type":"journal-article","created":{"date-parts":[[2025,8,12]],"date-time":"2025-08-12T09:47:07Z","timestamp":1754992027000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Rethinking Radiation Therapy for Perineural Invasion in Oral Cancer: Does More Coverage Improve Outcomes?"],"prefix":"10.1002","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0744-4838","authenticated-orcid":false,"given":"Sarbani","family":"Ghosh Laskar","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology Tata Memorial Centre, Homi Bhabha National Institute  Mumbai 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