A Total Radiation Dose of 70 Gy Is Required After Macroscopically Incomplete Resection of Squamous Cell Carcinoma of the Head and Neck.
OBJECTIVE
To contribute to the definition of the optimal total radiation dose and to determine the role of concurrent chemotherapy after macroscopically incomplete resection of squamous cell carcinoma of the head and neck (SCCHN).


METHODS
Twenty-six patients treated with postoperative radio(chemo)therapy following macroscopically incomplete resection were evaluated. Total radiation dose (70 Gy vs. 59.4-66 Gy), concurrent chemotherapy (yes vs. no) plus six factors were investigated for locoregional control (LRC) and overall survival (OS).


RESULTS
On analyses of LRC, 70 Gy was significantly superior to 59.4-66.0 Gy. Two-year LCR rates were 94% and 25%, respectively (p<0.001). Concurrent chemotherapy significantly improved 2-year LRC (90% vs. 0%, p<0.001). Both 70 Gy (92% vs. 11%, p<0.001) and concurrent chemotherapy (80% vs.0%, p<0.001) also resulted in better OS.


CONCLUSIONS
A total radiation dose of 70 Gy was significantly superior to lower doses regarding both LCR and OS. Concurrent chemotherapy is also very important to achieve optimal outcomes.
Department of Radiation Oncology, University of Lübeck, Lübeck, Germany rades.dirk@gmx.net.
Dirk
D
Rades
Medical Practice for Radiotherapy and Radiation Oncology, Hannover, Germany.
Stefan
S
Janssen
Department of Radiation Oncology, University Medical Center, Hamburg, Germany.
Amira
A
Bajrovic
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Republic of Slovenia.
Primoz
P
Strojan
Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A.
Steven E
SE
Schild
D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D059248:Chemoradiotherapy; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D011879:Radiotherapy Dosage; D000077195:Squamous Cell Carcinoma of Head and Neck
SCCHN; concurrent chemotherapy; locoregional control; macroscopically incomplete resection; survival; total radiation dose