title: Neck dissection followed by chemoradiotherapy for stage IV (N+) oropharynx cancer.
abstract: 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.
authors.affiliation: Department of Radiation Oncology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Andrew
authors.initials: A
authors.lastname: Cupino
authors.forename: Rita
authors.initials: R
authors.lastname: Axelrod
authors.forename: P Rani
authors.initials: PR
authors.lastname: Anne
authors.forename: Kulbir
authors.initials: K
authors.lastname: Sidhu
authors.forename: Jorosali
authors.initials: J
authors.lastname: Lavarino
authors.forename: Brian
authors.initials: B
authors.lastname: Kung
authors.forename: Marc
authors.initials: M
authors.lastname: Rosen
authors.forename: William
authors.initials: W
authors.lastname: Keane
authors.forename: Mitchell
authors.initials: M
authors.lastname: Machtay
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents