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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
Author(s) -
Mohanti Bidhu K.,
Thakar Alok,
Kaur Jaspreet,
Bahadur Sudhir,
Malik Monica,
Gandhi Ajeet K.,
Bhasker Suman,
Sharma Atul
Publication year - 2017
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/hed.24836
Subject(s) - medicine , radiation therapy , head and neck squamous cell carcinoma , port (circuit theory) , head and neck cancer , basal cell , head and neck , surgery , carcinoma , nuclear medicine , electrical engineering , engineering
Background This study compared 2 sequential cohorts to identify the postoperative radiotherapy (PORT) dose requirement for head and neck squamous cell carcinoma (HNSCC). Methods Two distinct PORT dose regimens were prescribed over 11 years; group 1 received 56 Gy or less, and group 2 received 60 Gy or more. The 2D and 3D techniques were used. Results Two sequential cohorts consisted of 478 patients, with mean and median follow‐up for group 1 and 2 as: 37.0 versus 28.5 months and 13.8 versus 13.1 months, respectively. Grades 3‐4 mucosal toxicities (11.4% vs 28.3%), hospitalization (3.2% vs 17.4%), and nasogastric feeding (11.9% vs 29.7%) were higher in group 2. The 2‐year disease‐free survival (DFS) was higher with PORT >60 Gy for the following factors: age ≤ 50 years ( P  = .041); ≥ 4 positive nodes ( P  = .029); and overall treatment time (OTT) ≥ 100 days ( P  = .042). Conclusion Except for the benefit of doses >60 Gy for limited parameters, a lower PORT dose did not compromise the results and can potentially reduce the morbidities and healthcare costs.

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