Presenter: Ang, KK
Affiliation: MD Anderson Cancer Center
We know from the literature that certain patients are at higher risk for postoperative recurrence based on previously described adverse prognostic features. This prospective study was performed to determine:
Materials and Methods:
Two hundred eighty-eight patients with locally advanced sqamous cell carcinoma of the head and neck were prspectively registered in this trial. They underwent radical surgery and were then defined by risk groups based on the following adverse clinicopathologic features: extracapsular extension (ECE)/neck soft tissue extension (STE), oral cavity primary, microsopically positive margins, nerve invasion, >1 neck nodes, >1 positive nodal groups, node size >3cm, and >6 week interval between surgery and radiation. Patients with none of these factors were defined as low risk and received no further treatment after surgery (n=31). Patients with one adverse factor other than ECE/STE were defined as intermediate risk and received lower dose (57.6 Gy) standard fractionation postoperative RT (n=31). Patients with two or more factors or ECE/STE were defined as high risk and were randomized to higher dose (63 Gy) standard fractionation versus higher dose (63 Gy) altered fractionation with a concomitant boost technique. This shortened the RT treatment time from 7 weeks to 5 weeks. The median followup for the entire group was 59 months.
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