Tolerability, toxicity, and temporal implications of transoral robotic surgery (TORS) on adjuvant radiation therapy in carcinoma of the head and neck.
OBJECTIVE
Overall treatment package time (from surgery to radiotherapy [RT] completion) > 100 days can portend poor outcomes in head and neck cancer. Faster postoperative recovery seen with transoral robotic surgery may decrease treatment duration and toxicity for adjuvant RT and chemoradiation.


METHODS
We retrospectively reviewed all patients treated with transoral robotic surgery (n = 124) and adjuvant RT and chemoradiation (n = 33) at our institution for head and neck cancer from April 2007 to December 2011 to determine treatment duration, acute toxicity, and long-term percutaneous gastric tube rates.


RESULTS
The median overall treatment time was 86 days and from surgery to RT start was 41 days; median RT duration was 44 days. No wound breakdown or infection occurred during or after RT. Two-year actuarial locoregional control, distant metastasis-free survival, and overall survival rates were 93%, 96%, and 97%, respectively.


CONCLUSIONS
Adjuvant RT after transoral robotic surgery for head and neck cancer can be completed safely and in a timely fashion. Longer follow-up and a larger cohort will be needed to determine if this regimen is more effective than traditional surgery followed by adjuvant RT.
Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY, USA.
Todd J
TJ
Carpenter
Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY, USA.
Benjamin
B
Kann
Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY, USA.
Michael H
MH
Buckstein
Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY, USA.
Eric C
EC
Ko
Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY, USA.
Richard L
RL
Bakst
Department of Medicine, Mount Sinai Medical Center, New York, NY, USA.
Krzysztof J
KJ
Misiukiewicz
Department of Medicine, Mount Sinai Medical Center, New York, NY, USA.
Marshall R
MR
Posner
Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Medical Center, New York, NY, USA.
Eric M
EM
Genden
Department of Radiation Oncology, Mount Sinai Medical Center, New York, NY, USA vishal.gupta@mountsinai.org.
Vishal
V
Gupta
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D013524:Surgical Flaps; D013997:Time Factors
adjuvant radiation; head and neck cancer; intensity-modulated radiation therapy; transoral robotic surgery