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

Publication/Presentation Date

7-1-2019

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.

Volume

41

Issue

7

First Page

2133

Last Page

2142

ISSN

1097-0347

Disciplines

Medicine and Health Sciences

PubMedID

30737968

Department(s)

Department of Surgery

Document Type

Article

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