Postoperative Radiotherapy for Squamous Cell Carcinoma of the Head and Neck

Abstract

This review discusses the role of postoperative radiotherapy (RT) for patients with squamous cell carcinoma of the head and neck. Patients with unfavorable pathologic features have a high-risk of local-regional recurrence and a decreased likelihood of survival after surgery alone. Postoperative RT reduces the risk of local-regional failure and probably improves survival. Patients who are at high risk for recurrence may benefit from more aggressive altered fractionation schedules to decrease the overall time from surgery to the completion of RT. Adjuvant cisplatin-based chemotherapy also appears to improve the probability of cure in high-risk patients.

Cisplatin superior to carboplatin in adjuvant radiochemotherapy for locally advanced cancers of the oropharynx and oral cavity

“…In the retrospective series of Hinerman et al [6], patients of the unfavorable category (three or more indications for postoperative RT) had a higher risk of locoregional failure if the interval between surgery and RT exceeded 51 days. In their review article, Mendenhall et al [11] defined an interval of > 6 weeks as a negative prognostic factor in high-risk patients. Because the patients included in our present study were high-risk patients, our results were in accordance with the literature findings.…”

Postoperative radiotherapy dose requirement in standard combined-modality practice for head and neck squamous cell carcinoma: Analysis of salient surgical and radiotherapy parameters in 2 cohorts

“…Similar time factor dependence has been reported in the literature substantiating our cohort study. 1,5,15,[17][18][19] The OTT calculated from the date of surgery to the last day of irradiation is an important prognostic factor for local recurrence in head and neck cancers. This has been attributed to exponential tumor cell repopulation occurring after surgery and is considered an important determinant of PORT in head and neck cancers.…”

Improved survival in HPV/p16-positive oropharyngeal cancer patients treated with postoperative radiotherapy

“…after resection of a stage iii/iV tumor, surgery is usually followed by radiotherapy (rt), since this treatment concept has shown improved locoregional control and survival [7,17,18]. However, various risk factors may necessitate either an intensification of the radiotherapeutic protocol or the addition of chemotherapy to postoperative irradiation [4].…”