title: Outcomes after radiotherapy for basaloid squamous cell carcinoma of the head and neck: a case-control study.
abstract: BACKGROUND
  Basaloid squamous cell carcinoma (BSCC) is an uncommon, high-grade variant of squamous cell carcinoma (SCC) of the head and neck. Its poorer prognosis compared with common SCC remains controversial. The authors investigated the outcomes of patients with BSCC who received radiotherapy and compared them with the outcomes of patients with SCC.
  
  
  METHODS
  From 1994 to 2004, 1007 patients received radiotherapy for head and neck carcinoma with lymph node involvement. The histologic types consisted of 51 BSCC, 431 poorly differentiated SCC (PSCC), and 525 well or moderately differentiated SCC (WMSCC). A case-control analysis was performed with BSCC matched against both PSCC and WMSCC to compare disease-control and survival rates.
  
  
  RESULTS
  Patients with BSCC received treatment modalities similar to those received by patients with SCC: They received induction chemotherapy (12%) or concurrent chemotherapy (33%), and a median radiation dose of 70 Gray. Posttreatment viable tumor was present in 44%, 13%, and 28% of neck dissection specimens from patients with BSCC, PSCC, and WMSCC, respectively. The 5-year disease-free survival rates (63%, 77%, and 76%, respectively) and overall survival rates (85%, 70%, and 71%, respectively) demonstrated no statistically significant differences for BSCC, PSCC, or WMSCC, respectively.
  
  
  CONCLUSIONS
  In this study, a poorer prognosis could not be demonstrated for irradiated patients with BSCC compared with either PSCC or WMSCC. All patients in this study had positive lymph node status, and the majority of patients (84%) had oropharyngeal cancer. The BSCC cohort did have a relatively high rate of viable tumor in their posttreatment neck dissections, and they had a relatively high rate of distant disease. On the basis of the high rate of lung metastases and the possibility of efficient salvage, the authors recommend obtaining a chest computed tomography scan during initial staging and follow-up.
authors.affiliation: Department of Radiation Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
authors.forename: Juliette
authors.initials: J
authors.lastname: Thariat
authors.forename: Anesa
authors.initials: A
authors.lastname: Ahamad
authors.forename: Adel K
authors.initials: AK
authors.lastname: El-Naggar
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Williams
authors.forename: Floyd C
authors.initials: FC
authors.lastname: Holsinger
authors.forename: Bonnie S
authors.initials: BS
authors.lastname: Glisson
authors.forename: Pamela K
authors.initials: PK
authors.lastname: Allen
authors.forename: William H
authors.initials: WH
authors.lastname: Morrison
authors.forename: Randal S
authors.initials: RS
authors.lastname: Weber
authors.forename: K Kian
authors.initials: KK
authors.lastname: Ang
authors.forename: Adam S
authors.initials: AS
authors.lastname: Garden
mesh_terms: D000328:Adult; D000368:Aged; D002281:Carcinoma, Basosquamous / Q000532:radiotherapy*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D016022:Case-Control Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D011879:Radiotherapy Dosage; D015996:Survival Rate