Postoperative radiotherapy for insecure or positive surgical margins in head and neck cancer.
OBJECTIVE
Our goal was to determine dose adequacy in postoperative irradiation for insecure or positive resection margins in patients with head and neck cancer.


METHODS
A retrospective medical chart review was performed in 36 consecutive patients with "close" or "positive" surgical margins who were treated with radiation after definitive surgery for cancer of the upper aerodigestive tract during a 20-year period.


RESULTS
The 5-year estimated overall and disease-free survival rates were 25%. The overall locoregional failure rate was 15%. The failure rate in the primary tumor bed and upper neck was 25% with an administered total dose of less than 60 Gy and 8% with 60 Gy or more; the relapse rate in the lower neck was 3%. Of several factors examined as predictors for locoregional recurrence, none proved to be of significance.


CONCLUSIONS
The observations from this study warrant data from prospective randomized trials before a definitive recommendation of postoperative radiotherapy dose escalation in cases of insecure or positive surgical margins is made.
Ampil
Federico L
FL
Division of Radiation Oncology, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA. fampil@lsuhsc.edu
Caldito
Gloria
G
Ghali
Ghali E
GE
Nathan
Cherie Ann O
CO
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000532:radiotherapy*; D011182:Postoperative Care; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D017211:Treatment Failure