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Avkshtol V, Handorf EA, Ridge JA, Leachman BK, Liu JC, Bauman J, Galloway TJ
Examining adjuvant radiation dose in head and neck squamous cell carcinoma
Head Neck (2019) 41:2133-2142.
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 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.
Publication Date: 2019-07-01.
Last updated on Saturday, August 22, 2020