Radiation plus surgery improves survival for head, neck cancer patients

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Adding radiation therapy to surgery significantly improves overall survival in patients diagnosed with node-positive head and neck cancer when compared to treating with surgery alone, according to a study in the June issue of International Journal of Radiation Oncology*Biology*Physics.

Very few studies have been conducted to determine its impact on survival, according to the study’s authors. Researchers at the Mount Sinai School of Medicine departments of radiation oncology and otolaryngology and head and neck surgery in New York City, sought to determine the impact of radiation and surgery on head and neck cancer patients’ overall survival with this study.

Between 1988 and 2001, 5,297 patients with a median age of 59 who were diagnosed with node-positive head and neck squamous cell carcinoma were treated with surgery and/or adjuvant radiation therapy, according to the authors.

The researchers surveyed patients approximately 4.4 years after treatment, and found that adding radiation to surgery improved patients’ chance of survival by 25 percent in all nodal stages (N1-N3), including N1 stage patients, even though radiation is typically recommended only for N2 and N3 stage patients.

Investigators found that the adjuvant radiation therapy significantly improved five-year overall survival (46.3 percent for surgery plus radiation therapy vs. 35.2 percent for surgery alone) and cancer-specific survival (54.8 percent for surgery plus radiation therapy vs. 46.2 percent for surgery alone).

“This study provides evidence that radiation should be considered after surgery for most head and neck cancer patients with positive lymph nodes,” said lead author Johnny Kao, MD, assistant professor of radiation oncology at Mount Sinai.

“For these patients, adding radiation improves not only locoregional control but also greatly increases their chance for overall survival. The findings of this study should serve to enhance the use of adjuvant radiation as the most effective treatment method for these types of cancer,” Kao added.