Examining adjuvant radiation dose in head and neck squamous cell carcinoma

Vladimir Avkshtol, Elizabeth A. Handorf, John A. Ridge, Brooke K. Leachman, Jeffrey C. Liu, Jessica Bauman, Thomas J. Galloway

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Compare adjuvant radiation dose trends and outcomes in head and neck squamous cell carcinoma (HNSCC). Methods: Nonmetastatic HNSCCs treated between 2004 and 2014 with primary site surgery, lymph node dissection, and adjuvant radiation were identified in the National Cancer Database. Standard dose radiation (SD-RT) was defined as an equivalent dose in 2 Gy (EQD2) ≥56.64 and ≤60 Gy and high-dose radiation (HD-RT) as an EQD2 >60 and <70 Gy. Results: HD-RT was given to 46% of the 15 836 HNSCC patients managed with adjuvant radiation. When adjusted for poor prognostic factors, HD-RT was associated with increased mortality (HR1.09; 95%CI 1.02-1.16). In nonoropharynx or human papillomavirus-negative oropharynx primary that had positive margins, ≥5 positive lymph nodes, and/or extranodal extension, HD-RT was still not associated with improved survival (HR 1.01, 95% CI 0.91-1.12). Conclusions: There was no survival benefit from postoperative dose escalation above EQD2 60 Gy even in a high-risk cohort.

Original languageEnglish (US)
Pages (from-to)2133-2142
Number of pages10
JournalHead and Neck
Issue number7
StatePublished - Jul 2019
Externally publishedYes


  • adjuvant
  • dose
  • head and neck cancer
  • postoperative
  • radiation

ASJC Scopus subject areas

  • Otorhinolaryngology


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