Neck dissection followed by chemoradiotherapy for stage IV (N+) oropharynx cancer.
OBJECTIVE
This study evaluated the strategy of performing neck dissection (ND) without primary tumor resection prior to definitive chemoradiotherapy (CRT) for N2+ oropharynx cancer.


METHODS
We analyzed records of 25 patients who underwent ND before concurrent CRT with weekly low-dose concurrent paclitaxel and a platinum compound. The extent of ND was highly customized (1 to 39 nodes) and median radiotherapy dose was 70 Gy.


RESULTS
Median follow-up was 36 months. Two-year and 3-year actuarial locoregional control rates were 95% and 88%. No patient had regional neck nodal failure. Two-year rate of freedom from distant metastases was 91%. The 2- and 3-year event-free survival rates were 88% and 75%. Fifteen percent had Grade 3+ late toxicity; none had permanent gastrostomy tube dependence.


CONCLUSIONS
Neck dissection without primary tumor resection before definitive chemoradiotherapy for oropharynx cancer is a safe and effective management program and warrants further exploration.
Cupino
Andrew
A
Department of Radiation Oncology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Axelrod
Rita
R
Anne
P Rani
PR
Sidhu
Kulbir
K
Lavarino
Jorosali
J
Kung
Brian
B
Rosen
Marc
M
Keane
William
W
Machtay
Mitchell
M
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods*; D020360:Neoadjuvant Therapy / Q000379:methods; D009959:Oropharyngeal Neoplasms / Q000473:pathology / Q000628:therapy*; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D016896:Treatment Outcome
D000970:Antineoplastic Agents