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.
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.
['Mohanti|Bidhu K|BK|0000-0002-7553-0984', 'Thakar|Alok|A|', 'Kaur|Jaspreet|J|', 'Bahadur|Sudhir|S|', 'Malik|Monica|M|', 'Gandhi|Ajeet K|AK|0000-0001-5713-0963', 'Bhasker|Suman|S|', 'Sharma|Atul|A|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D002294:Carcinoma, Squamous Cell D015331:Cohort Studies D003131:Combined Modality Therapy D018572:Disease-Free Survival D004307:Dose-Response Relationship, Radiation D005260:Female D006258:Head and Neck Neoplasms D006801:Humans D008297:Male D008875:Middle Aged D011379:Prognosis D011879:Radiotherapy Dosage D018714:Radiotherapy, Adjuvant D012189:Retrospective Studies D018570:Risk Assessment D000077195:Squamous Cell Carcinoma of Head and Neck D016019:Survival Analysis D016896:Treatment Outcome
postoperative radiotherapy dose head neck squamous cell carcinoma (HNSCC) prognostic features