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Precisely defining high‐risk operable head and neck tumors based on rtog #85‐03 and #88‐24: Targets for postoperative radiochemotherapy?
Author(s) -
Cooper Jay S.,
Pajak Thomas F.,
Forastiere Arlene,
Jacobs John,
Fu Karen K.,
Ang Kian K.,
Laramore George E.,
AlSarraf Muhyi
Publication year - 1998
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/(sici)1097-0347(199810)20:7<588::aid-hed2>3.0.co;2-f
Subject(s) - medicine , radiation therapy , head and neck , surgery , disease , head and neck cancer , chemotherapy , oncology
Background Local‐regional recurrence of disease remains the major obstacle to cure of advanced head and neck cancers. Methods This investigation reviewed data derived from Radiation Therapy Oncology Group (RTOG) protocols #85‐03 and #88‐24 to identify characteristics of tumors that predicted local‐regional recurrence of disease following surgery and postoperative radiotherapy (RT). Results The presence of tumor in two or more lymph nodes, and/or extracapsular spread of nodal disease, and/or microscopic‐size tumor involvement of the surgical margins of resection imparts a high risk of local‐regional (L‐R) relapse. Our data also support the hypothesis that, following surgery, the concurrent addition of chemotherapy (CT) to RT may increase the likelihood of L‐R control of disease for patients who have these high‐risk characteristics. Conclusion A prospective trial of surgery followed by concurrent RT and CT is warranted for patients who have high‐risk characteristics found at surgery. © 1998 John Wiley & Sons, Inc. Head Neck 20: 588–594, 1998.