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Updated: Jan 29, 2026

A Model for Perineural Invasion in Head and Neck Squamous Cell Carcinoma
Published on: January 5, 2017
Examining adjuvant radiation dose in head and neck squamous cell carcinoma
Vladimir Avkshtol1, Elizabeth A Handorf2, John A Ridge3
1Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania.
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.
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