Planned neck dissection following chemo-radiotherapy in advanced HNSCC

International Seminars in Surgical Oncology : ISSO
Tejpal Gupta, Jai Prakash Agarwal

Abstract

BACKGROUND: Neck dissection has traditionally played an important role in the management of patients with regionally advanced head and neck squamous cell carcinoma (HNSCC) treated with radical radiotherapy alone. However, with the incorporation of chemotherapy in the therapeutic strategy for advanced HNSCC and resultant improvement in outcome the routine use of post chemo-radiotherapy neck dissection is being questioned. METHODS: Published data for this review was identified by systematically searching MEDLINE, CANCERLIT & EMBASE databases from 1995 until date with restriction to the English language. RESULTS: There is lack of high quality evidence on the role of planned neck dissection in advanced HNSCC treated with chemo-radiotherapy. A systematic literature search could identify only one small randomized controlled trial (Level I evidence) addressing this issue, albeit with major limitations. Upfront neck dissection followed by chemo-radiotherapy resulted in better disease-specific survival as compared to chemoradiation only. Several single arm prospective and retrospective reports were also identified with significant heterogeneity and often-contradictory conclusions. CONCLUSIONS: Planned neck dissection after radical chemo...Continue Reading

References

Sep 1, 1995·Archives of Otolaryngology--head & Neck Surgery·W M KochA Forastiere
Feb 26, 1999·Archives of Otolaryngology--head & Neck Surgery·P LavertuB G Wood
Feb 15, 2001·Archives of Otolaryngology--head & Neck Surgery·G L ClaymanS M Lippman
Jun 16, 2001·Head & Neck·G P BrowmanUNKNOWN Cancer Care Ontario Practice Guideline Initiative Head and Neck Cancer Disease Site Group
Jun 18, 2002·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Lynn M SchuchterUNKNOWN American Society of Clinical Oncology Chemotherapy and Radiotherapy Expert Panel
Feb 1, 2003·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Gerhard G GrabenbauerStefan Schultze-Mosgau
Dec 31, 2003·Current Treatment Options in Oncology·Madhur Garg, Jonathan J Beitler
Mar 31, 2004·International Journal of Radiation Oncology, Biology, Physics·David M BrizelRichard L Scher

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