The impact of radiation therapy on survival for various subgroups of node-positive head and neck squamous cell carcinoma has not been clearly demonstrated. Researchers from Mount Sinai School of Medicine, Departments of Radiation Oncology, Otolaryngology, and Head and Neck Surgery, New York, New York, sought to determine the impact of radiation and surgery on overall survival among patients with head and neck cancer.

Using the Surveillance, Epidemiology, and End Results (SEER) database (1988-2001), researchers identified 5,297 patients (mean age 59 years) who were diagnosed with node-positive head and neck squamous cell carcinoma and treated with surgery and/or adjuvant radiation therapy. The patients were surveyed approximately 4.4 years after treatment.

Researchers found that adding adjuvant radiation therapy to surgery improved patients' chances of survival by 25% in all nodal stages (N1-N3) including N1 stage patients, even though radiation is typically recommended only for N2 and N3 stage patients.

"This study provides evidence that radiation should be considered after surgery for most head and neck cancer patients with positive lymph nodes," said lead author Johnny Kao, MD, Mount Sinai School of Medicine.

"For these patients, adding radiation improves not only locoregional control but also greatly increases their chance for overall survival. The findings of this study should serve to enhance the use of adjuvant radiation as the most effective treatment method for these types of cancer."


SOURCE: American Society for Therapeutic Radiology and Oncology

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