Head and neck squamous cell carcinoma: The role of post‐operative adjuvant radiotherapy

Dinshaw, Ketayun A.; Agarwal, Jai Prakash; Laskar, Sarbani Ghosh; Gupta, Tejpal; Shrivastava, Shyam Kishore; Cruz, Anil D’

doi:10.1002/jso.20274

Cited by 18 publications

(13 citation statements)

References 18 publications

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“…However, no difference was identified in LC, LRC and DFS either in the entire cohort or the subgroups. Lack of discrimination in outcomes with regard to T stage could be due to the limitation in the pathological staging system in the present series and other series [15] points out the fallacy of T staging on OCSCC and need to re-examine the T grouping in OCSCC.…”

Section: T Stagecontrasting

confidence: 51%

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Analysis of prognostic factors in 1180 patients with oral cavity primary cancer treated with definitive or adjuvant radiotherapy

et al. 2010

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Section: T Stagecontrasting

confidence: 51%

“…Apart from nodal involvement, presence of PNE has been postulated as an independent adverse prognostic factor. [15] Patients with PNE had inferior LRC and DFS as compared to those without PNE. Aggressive treatment with addition of chemotherapy and escalation of dose improves outcomes in these patients [18,19] …”

Section: Cut Margin and Perinodal Extension (Pne)mentioning

confidence: 93%

Analysis of prognostic factors in 1180 patients with oral cavity primary cancer treated with definitive or adjuvant radiotherapy

et al. 2010

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“…A retrospective review of 348 previously untreated patients with head and neck squamous cell cancer (HNSCC) who received postoperative radiotherapy (PORT) following curative surgery was performed at the authors' institution [10]. With a median follow-up of 36 months (range: 2-127 months) for surviving patients, the 5-year local control, locoregional control and disease-free survival (DFS) were 79, 63 and 56%, respectively for all patients.…”

Section: Tata Memorial Hospital Experiencementioning

confidence: 99%

Radiotherapeutic management of locally advanced head and neck cancer

Laskar¹,

Agarwal²,

Srinivas³

et al. 2006

Expert Review of Anticancer Therapy

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Head and neck cancer management has undergone several paradigm shifts for several relevant reasons. From the dismal experience with the use of radiotherapy as the sole modality in the treatment of this group of patients with advanced disease, radiotherapy has been evaluated as an adjuvant for the same group of patients who had undergone successful surgery. Although there is no level 1 evidence to support postoperative adjuvant radiation, several studies have demonstrated that adjuvant radiotherapy reduces the local failures and, thereby, improves survival. Predictors of recurrence after surgical resection are: positive margins of resection; extranodal spread in involved nodes; perineural invasion; and presence of two or more involved regional lymph nodes. Realization of the advantages of a combination of chemotherapy with radiotherapy has had a major impact on the management of these cancers. There is emerging evidence for the use of adjuvant concurrent chemoradiotherapy in the group with high-risk features. Multiple organ conservation strategies in the management of locally advanced head and neck cancers have evolved over the years. However, the meta-analyses of impact of chemotherapy in various settings reveal that concomitant chemoradiotherapy is superior to any of the other regimens. Increasing use of computed tomography, magnetic resonance imaging and positron emission tomography scan images has resulted in better visualization of target volumes and critical structures. Delineation of these structures is of paramount importance and has resulted in a profound change in conformal treatment planning. Better understanding of the physical aspects of delivery of radiotherapy and the advent of modern treatment planning systems have led to the development of conformal techniques. Although the benefit of these techniques on survival have yet to be demonstrated, there is evidence to suggest that they reduce treatment-related toxicities significantly and facilitate dose escalation. Increased knowledge of radiobiology has led to the development of various altered fractionation regimens in the management of locally advanced head and neck cancers. Discovery of cell-cycle kinetics and signal transduction pathways has led to the unearthing of several potential targets for targeted therapy. The epidermal growth factor receptor gene has emerged as the most promising target. The role of biological radiation response modifiers is evolving. All of these approaches to improve the therapeutic gain would be incomplete without evaluating their effect on the quality of life of these patients.

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“…Although studies have shown that a combination of surgery and adjuvant RT increases overall survival (OS) and locoregional control [17,29,37], the improvements are modest [17,29,37,41]. Several studies have demonstrated that addition of chemotherapy (CT) to adjuvant RT may be beneficial for patients with advanced OSCC [1,2,14,47,49].…”

Section: Introductionmentioning

confidence: 99%

Combined-modality treatment in advanced oral squamous cell carcinoma

et al. 2011

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Head and neck squamous cell carcinoma: The role of post‐operative adjuvant radiotherapy

Abstract: Primary site and PNE are independent factors predicting outcome in the postoperative radiotherapeutic management of HNSCC.

Cited by 18 publications

References 18 publications

Analysis of prognostic factors in 1180 patients with oral cavity primary cancer treated with definitive or adjuvant radiotherapy

Analysis of prognostic factors in 1180 patients with oral cavity primary cancer treated with definitive or adjuvant radiotherapy

Radiotherapeutic management of locally advanced head and neck cancer

Combined-modality treatment in advanced oral squamous cell carcinoma

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