Shoulder symptoms and quality of life impact of limited neck dissection after de-intensified chemoradiotherapy: Secondary analysis of two prospective trials

Kyle Wang, Dominic H. Moon, Robert J. Amdur, Roi Dagan, Nathan C. Sheets, Colette J. Shen, Rebecca Green, Samip N. Patel, Adam M. Zanation, Brian D. Thorp, Trevor G. Hackman, Mark C. Weissler, William M. Mendenhall, Bhishamjit S. Chera

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background: We investigated the quality of life (QOL) impact of post-radiation therapy (RT) superselective/selective neck dissection after de-intensified chemoradiation for human papillomavirus-associated oropharynx cancer. Methods: A total of 147 patients received 60 Gy and weekly low-dose cisplatin on two phase 2 trials with planned post-RT neck dissection or surveillance positron emission tomography with neck dissection reserved for salvage. UW-QOL Shoulder Score, EORTC H&N-35, and EAT-10 were assessed. Results: In all, 48 of 147 patients had post-RT neck dissection. At 2 years, 37% and 13% of patients receiving post-RT neck dissection had Shoulder Score ≥ 1 (any shoulder symptoms) and ≥ 2 (symptoms affecting work/hobbies), respectively, versus only 16% and 3% of patients not receiving post-RT neck dissection. Post-RT neck dissection was associated with Shoulder Score ≥ 1 (P = 0.005) and Shoulder Score ≥ 2 (P = 0.03) at 2 years, but not H&N-35 or EAT-10 scores. Conclusions: Post-RT superselective/selective neck dissection was associated with modest but persistent shoulder symptoms. These toxicities should be weighed against the probability of persistent disease when evaluating patients for post-RT neck dissection.

Original languageEnglish (US)
Pages (from-to)1213-1219
Number of pages7
JournalHead and Neck
Volume41
Issue number5
DOIs
StatePublished - May 2019
Externally publishedYes

Keywords

  • neck dissection
  • oropharynx
  • quality of life
  • radiation
  • shoulder

ASJC Scopus subject areas

  • Otorhinolaryngology

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    Wang, K., Moon, D. H., Amdur, R. J., Dagan, R., Sheets, N. C., Shen, C. J., Green, R., Patel, S. N., Zanation, A. M., Thorp, B. D., Hackman, T. G., Weissler, M. C., Mendenhall, W. M., & Chera, B. S. (2019). Shoulder symptoms and quality of life impact of limited neck dissection after de-intensified chemoradiotherapy: Secondary analysis of two prospective trials. Head and Neck, 41(5), 1213-1219. https://doi.org/10.1002/hed.25535