Omission of Postoperative Radiation for Node-Negative Head/Neck Cancer
Posted: Monday, August 26, 2019
By eliminating postoperative radiation therapy to the pathologically negative neck, patients with primary head and neck squamous cell carcinoma experience minimal long-term adverse effects on global quality of life, according to a prospective phase II study published in the Journal of Clinical Oncology. However, Jessika A. Contreras, MD, of the Washington University School of Medicine, and colleagues believe further studies are needed to confirm the benefit of this approach.
“To our knowledge, this is the first prospective study evaluating regional control outcomes in high-risk patients treated with postoperative radiation therapy to limited neck volumes,” the investigators concluded.
A total of 72 patients took part in this study. They had head and neck squamous cell carcinoma, had surgical resection and neck dissection with a pathologically negative neck, and high-risk qualities. Quality of life was analyzed with the MD Anderson Dysphagia Inventory and the University of Michigan patient-reported xerostomia questionnaire. Many patients (65%) had a smoking history.
Two patients reported treatment failure of the pathologically negative unirradiated neck after a median follow-up of 53 months. Unirradiated neck control was 97%. The 5-year rates of local control, regional control, progression-free survival, and overall survival were 84%, 93%, 60%, and 64%, correspondingly. Quality of life at 12 and 24 months after postoperative radiation therapy did not appear to vary significantly from baseline.
Disclosure: The study authors’ disclosure information can be found at ascopubs.org.