Examining adjuvant radiation dose in head and neck squamous cell carcinoma

Vladimir Avkshtol; Elizabeth A. Handorf; John A. Ridge; Brooke K. Leachman; Jeffrey C. Liu; Jessica Bauman; Thomas J. Galloway

doi:10.1002/hed.25680

Examining adjuvant radiation dose in head and neck squamous cell carcinoma

Vladimir Avkshtol, Elizabeth A. Handorf, John A. Ridge, Brooke K. Leachman, Jeffrey C. Liu, Jessica Bauman, Thomas J. Galloway

Fox Chase Cancer Center

Research output: Contribution to journal › Article › peer-review

8 Scopus citations

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.

Original language	English
Pages (from-to)	2133-2142
Number of pages	10
Journal	Head and Neck
Volume	41
Issue number	7
DOIs	https://doi.org/10.1002/hed.25680
State	Published - Jul 2019

Keywords

Adult
Aged
Carcinoma, Squamous Cell/mortality
Female
Head and Neck Neoplasms/mortality
Humans
Lymph Node Excision
Male
Middle Aged
Prognosis
Radiotherapy Dosage
Radiotherapy, Adjuvant

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1002/hed.25680

Cite this

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title = "Examining adjuvant radiation dose in head and neck squamous cell carcinoma",

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 = "Adult, Aged, Carcinoma, Squamous Cell/mortality, Female, Head and Neck Neoplasms/mortality, Humans, Lymph Node Excision, Male, Middle Aged, Prognosis, Radiotherapy Dosage, Radiotherapy, Adjuvant",

author = "Vladimir Avkshtol and Handorf, {Elizabeth A.} and Ridge, {John A.} and Leachman, {Brooke K.} and Liu, {Jeffrey C.} and Jessica Bauman and Galloway, {Thomas J.}",

note = "Publisher Copyright: {\textcopyright} 2019 Wiley Periodicals, Inc.",

year = "2019",

month = jul,

doi = "10.1002/hed.25680",

language = "English",

volume = "41",

pages = "2133--2142",

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issn = "1043-3074",

publisher = "John Wiley & Sons Inc.",

number = "7",

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T1 - Examining adjuvant radiation dose in head and neck squamous cell carcinoma

AU - Avkshtol, Vladimir

AU - Handorf, Elizabeth A.

AU - Ridge, John A.

AU - Leachman, Brooke K.

AU - Liu, Jeffrey C.

AU - Bauman, Jessica

AU - Galloway, Thomas J.

PY - 2019/7

Y1 - 2019/7

N2 - 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.

AB - 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.

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KW - Lymph Node Excision

KW - Male

KW - Middle Aged

KW - Prognosis

KW - Radiotherapy Dosage

KW - Radiotherapy, Adjuvant

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Examining adjuvant radiation dose in head and neck squamous cell carcinoma

Abstract

Keywords

UN SDGs

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Examining adjuvant radiation dose in head and neck squamous cell carcinoma

Abstract

Keywords

UN SDGs

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