Format

Send to

Choose Destination
Head Neck. 2019 Jul;41(7):2133-2142. doi: 10.1002/hed.25680. Epub 2019 Feb 9.

Examining adjuvant radiation dose in head and neck squamous cell carcinoma.

Author information

1
Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
2
Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
3
Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
4
Department Medical Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.

Abstract

BACKGROUND:

Compare adjuvant radiation dose trends and outcomes in head and neck squamous cell carcinoma (HNSCC).

METHODS:

Nonmetastatic HNSCCs treated between 2004 and 2014 with primary site surgery, lymph node dissection, and adjuvant radiation were identified in the National Cancer Database. Standard dose radiation (SD-RT) was defined as an equivalent dose in 2 Gy (EQD2) ≥56.64 and ≤60 Gy and high-dose radiation (HD-RT) as an EQD2 >60 and <70 Gy.

RESULTS:

HD-RT was given to 46% of the 15 836 HNSCC patients managed with adjuvant radiation. When adjusted for poor prognostic factors, HD-RT was associated with increased mortality (HR1.09; 95%CI 1.02-1.16). In nonoropharynx or human papillomavirus-negative oropharynx primary that had positive margins, ≥5 positive lymph nodes, and/or extranodal extension, HD-RT was still not associated with improved survival (HR 1.01, 95% CI 0.91-1.12).

CONCLUSIONS:

There was no survival benefit from postoperative dose escalation above EQD2 60 Gy even in a high-risk cohort.

KEYWORDS:

adjuvant; dose; head and neck cancer; postoperative; radiation

PMID:
30737968
DOI:
10.1002/hed.25680

Supplemental Content

Full text links

Icon for Wiley
Loading ...
Support Center