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Patterns of failure among patients with squamous cell carcinoma of the head and neck who obtain a complete response to chemoradiotherapy

✍ Scribed by Susannah Yovino; Kathleen Settle; Rodney Taylor; Jeffrey Wolf; Young Kwok; Kevin Cullen; Robert Ord; Ann Zimrin; Scott Strome; Mohan Suntharalingam

Publisher
John Wiley and Sons
Year
2009
Tongue
English
Weight
92 KB
Volume
32
Category
Article
ISSN
1043-3074

No coin nor oath required. For personal study only.

✦ Synopsis

Abstract

Background.

The role of adjuvant neck dissection in patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) who obtain complete clinical and radiologic response following definitive chemoradiation treatment is controversial.

Methods.

Patterns of failure among 120 patients with locally advanced SCCHN, all with node‐positive disease, treated with concurrent chemoradiation, were analyzed.

Results.

Ninety‐one of the patients achieved a complete response and were observed without undergoing neck dissection. Isolated failure in the neck occurred in 2 patients. The most common site of failure was metastatic disease (17 patients). Six patients had recurrence at the primary only, and 1 experienced failure in the neck and at the primary. Partial responders with resectable disease underwent neck dissection following chemoradiation. This group had worse local control and overall survival compared with complete responders.

Conclusions.

We recommend observation after definitive chemoradiation for complete responders. Further research is needed to improve outcomes among partial responders. Β© 2009 Wiley Periodicals, Inc. Head Neck, 2010

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