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Shoulder symptoms and quality of life impact of limited neck dissection after de‐intensified chemoradiotherapy: Secondary analysis of two prospective trials
Author(s) -
Wang Kyle,
Moon Dominic H.,
Amdur Robert J.,
Dagan Roi,
Sheets Nathan C.,
Shen Colette J.,
Green Rebecca,
Patel Samip N.,
Zanation Adam M.,
Thorp Brian D.,
Hackman Trevor G.,
Weissler Mark C.,
Mendenhall William M.,
Chera Bhishamjit S.
Publication year - 2019
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.25535
Subject(s) - medicine , neck dissection , dissection (medical) , chemoradiotherapy , quality of life (healthcare) , surgery , radiation therapy , cancer , nursing
Background We investigated the quality of life (QOL) impact of post‐radiation therapy (RT) superselective/selective neck dissection after de‐intensified chemoradiation for human papillomavirus‐associated oropharynx cancer. Methods A total of 147 patients received 60 Gy and weekly low‐dose cisplatin on two phase 2 trials with planned post‐RT neck dissection or surveillance positron emission tomography with neck dissection reserved for salvage. UW‐QOL Shoulder Score, EORTC H&N‐35, and EAT‐10 were assessed. Results In all, 48 of 147 patients had post‐RT neck dissection. At 2 years, 37% and 13% of patients receiving post‐RT neck dissection had Shoulder Score ≥ 1 (any shoulder symptoms) and ≥ 2 (symptoms affecting work/hobbies), respectively, versus only 16% and 3% of patients not receiving post‐RT neck dissection. Post‐RT neck dissection was associated with Shoulder Score ≥ 1 ( P = 0.005) and Shoulder Score ≥ 2 ( P = 0.03) at 2 years, but not H&N‐35 or EAT‐10 scores. Conclusions Post‐RT superselective/selective neck dissection was associated with modest but persistent shoulder symptoms. These toxicities should be weighed against the probability of persistent disease when evaluating patients for post‐RT neck dissection.