INDICATIONS FOR RADIOTHERAPY AFTER NECK DISSECTION

Primoz Strojan, Alfio Ferlito*, Johannes A. Langendijk, Carl E. Silver

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

15 Citations (Scopus)

Abstract

Up-front surgery and postoperative radiotherapy constitute a well-recognized treatment concept for locally or regionally advanced squamous cell carcinoma of the head and neck. This "treatment package" is further intensified with the concomitant application of chemotherapy during irradiation when high-risk features (ie, microscopically involved resection margins, extracapsular extension of the tumor from neck nodes, the presence of soft tissue deposits) are found on histopathologic examination of a resected specimen. With regard to neck disease, however, the demarcation line between low- and higher-risk clinical situations, which would differ with respect to the need for postoperative radiotherapy, is not clear. In an attempt to define the low-risk characteristics of disease in the neck that do not require adjuvant irradiation, we reviewed the available literature reports for any direct or indirect evidence on the value of postoperative radiotherapy in various clinical scenarios. The number of positive lymph nodes found in a dissected tissue specimen that should be used as a "cut-off" point for introduction of postoperative radiotherapy was evaluated in the context of both primary tumor characteristics and type of neck dissection. (C) 2010 Wiley Periodicals, Inc. Head Neck 34: 113-119, 2012

Original languageEnglish
Pages (from-to)113-119
Number of pages7
JournalHead and Neck: Journal of the Sciences and Specialties of the Head and Neck
Volume34
Issue number1
DOIs
Publication statusPublished - Jan-2012

Keywords

  • neck dissection
  • postoperative radiotherapy
  • squamous cell carcinoma
  • head and neck
  • regional control
  • SQUAMOUS-CELL-CARCINOMA
  • UPPER AERODIGESTIVE TRACT
  • RECURSIVE PARTITIONING ANALYSIS
  • LYMPH-NODE METASTASIS
  • LOCALLY ADVANCED HEAD
  • PATHOLOGICAL N1 NECK
  • POSTOPERATIVE RADIOTHERAPY
  • SELECTIVE NECK
  • ADJUVANT RADIOTHERAPY
  • RADIATION-THERAPY

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