Postoperative strategies after primary surgery for squamous cell carcinoma of the head and neck☆

Received 24 February 2010; received in revised form 29 March 2010; accepted 29 March 2010. published online 20 April 2010.

Summary

This review discusses the role of adjuvant treatment after curative surgery for patients with head and neck squamous cell carcinoma (HNSCC). In general, patients with unfavourable prognostic factors have a high-risk of loco-regional recurrence and subsequent worse survival after surgery alone and are therefore considered proper candidates for adjuvant treatment by either postoperative radiotherapy alone or postoperative chemoradiation. Selection of the most optimal adjuvant treatment strategy should be based on the most important prognostic factors.

In this review, the different treatment strategies will be discussed in general. More specifically, we will discuss the role of the interval between surgery and radiotherapy, the overall treatment time of radiation, the selection of target volumes for radiation and the value of adding concomitant chemotherapy to postoperative radiation.

Keywords: Head and neck cancer, Squamous cell carcinoma, Postoperative radiotherapy, Postoperative chemoradiation

a Department of Radiation Oncology, University Medical Center Groningen/University of Groningen, Groningen, The Netherlands

b Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy

c Department of Otolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands

d Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain

e Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia

f Department of Medicine, Division of Oncology, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA

Corresponding author. Address: Department of Radiation Oncology, University Medical Center Groningen, P.O. Box 30001, 9300 RB Groningen, The Netherlands. Tel.: +31 50 3611190; fax: +31 50 3611692.

☆ This paper was written by members and invitees of the International Head and Neck Scientific Group (www.IHNSG.com).

PII: S1368-8375(10)00135-1

doi:10.1016/j.oraloncology.2010.03.023

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