According to an article recently published in the journal Cancer, the addition of radiation therapy following surgery improves survival in locally advanced head and neck cancer.
Head and neck cancers originate in the oral cavity (lip, mouth, tongue), salivary glands, paranasal sinuses, nasal cavity, pharynx (upper back part of the throat), larynx (voice box), and lymph nodes in the upper part of the neck. Worldwide, head and neck cancer is diagnosed in approximately 640,000 people annually and is responsible for approximately 350,000 deaths each year.
Squamous cell carcinoma of the head and neck (HNSCC) is the most common type of head and neck cancer. It originates in squamous cells, which are commonly part of the outermost layers of tissues. Locally advanced HNSCC refers to cancer that has spread from its site of origin to nearby lymph nodes or tissues. Standard treatment for this stage of disease typically consists of surgery and radiation therapy with or without chemotherapy. The impact of radiation therapy on survival, however, has not been clearly established.
Researchers from the Mount Sinai School of Medicine in New York recently conducted a clinical study to evaluate data from the Surveillance, Epidemiology, and End Results (SEER) database to determine the effect that radiation therapy has on survival for patients with locally advanced HNSCC. This study included 8,795 patients whose cancer had spread to their lymph nodes. They were treated either with surgery alone or surgery plus radiation therapy. Patients had been diagnosed with cancer between 1988 and 2001. The median follow-up was just over four years.
- At five years survival was improved among patients treated with radiation therapy (43.2%) compared with those treated with surgery only (33.4%).
- Death caused by the cancer occurred in approximately 50% of patients treated with surgery and radiation therapy compared with 78% of patients treated with surgery only.
The researchers concluded that the addition of “RT [radiation therapy] resulted in an approximately 10% absolute increase in 5-year cancer-specific survival and overall survival for patients with lymph node-positive HNSCC compared with surgery alone. Despite combined surgery and adjuvant RT, outcomes in this high-risk population remain suboptimal, emphasizing the need for continued investigation of innovative treatment approaches.”
Reference: Lavaf A, Genden E, Cesaretti J, Packer S, Kao J. Adjuvant radiotherapy improves overall survival for patients with lymph node-positive head and neck squamous cell carcinoma. Cancer. 2008; 12: 535 – 543.