Trial reportInternational journal of radiation oncology, biology, physics2017
Final Report of a Prospective Randomized Trial to Evaluate the Dose-Response Relationship for Postoperative Radiation Therapy and Pathologic Risk Groups in Patients With Head and Neck Cancer.
Trial report in International journal of radiation oncology, biology, physics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Association of Unilateral Radiotherapy With Contralateral Lymph Node Failure Among Patients With Squamous Cell Carcinoma of the Tonsil: A Systematic Review and Meta-analysis.JAMA network open · 2023Pooled it
- Pooled it
- Postoperative hyperfractionated IMRT with weekly cisplatin for head and neck cancer: phase IIa trial.Journal of radiation research · 2025Trial
- Clinically Interpretable Survival Risk Stratification in Head and Neck Cancer Using Bayesian Networks and Markov Blankets.International journal of radiation oncology, biology, physics · 2026Article
- Surgically Based Deintensification for Oropharyngeal Cancer: Current Concepts and Future Directions.Otolaryngologic clinics of North America · 2026Review
- Multiomic Selection of Cancer-Testis Antigens as Precision Immuno-oncologic Targets in Head and Neck Cancer.JAMA otolaryngology-- head & neck surgery · 2025Article
- Radiation therapy results in preferential tumor antigen-specific lymphodepletion in head and neck cancer.Nature communications · 2025Article
- Does severe mucositis impair oncological outcome in head and neck cancer patients? A pooled analysis of two prospective studies with long-term follow-up.BMC cancer · 2025Article
- Mannose and PMI depletion overcomes radiation resistance in HPV-negative head and neck cancer.Cell communication and signaling : CCS · 2025Article
- Comparative Analysis of Postoperative Radiotherapy Dose Escalation in Oral Cavity Cancer Patients with Positive Margins: A Propensity Score-Matched Study.South Asian journal of cancer · 2025Article
- Evaluating the radiosensitivity of the oral microbiome to predict radiation-induced mucositis in head and neck cancer patients: A prospective trial.Clinical and translational radiation oncology · 2025Article
- Treatment package time in high-risk oral cavity squamous cell carcinoma: where are we failing and at what cost?Reports of practical oncology and radiotherapy : journal of Greatpoland Cancer Center in Poznan and Polish Society of Radiation Oncology · 2025Article
- Advances and residual knowledge gaps in the neck management of head and neck squamous cell carcinoma patients with advanced nodal disease undergoing definitive (chemo)radiotherapy for their primary.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Review
- Type I interferon signaling promotes radioresistance in head and neck cancer.Translational cancer research · 2024Article
- Clinical outcomes and failure patterns after postoperative radiotherapy for oral cavity squamous cell carcinoma.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2024Article
- Reconstructive flap surgery in head and neck cancer patients: an interdisciplinary view of the challenges encountered by radiation oncologists in postoperative radiotherapy.Frontiers in oncology · 2024Review
- In Silico Analysis of Adjuvant Head and Neck Online Adaptive Radiation Therapy.Advances in radiation oncology · 2024Article
- Photoactivated HPPH-Liposomal therapy for the treatment of HPV-Negative head and neck cancer.Oral oncology · 2023Article
- Metastatic cutaneous squamous cell carcinoma to the parotid: Adjuvant radiotherapy and treatment outcomes.Journal of medical radiation sciences · 2023Article
- Postoperative radiotherapy for supraglottic cancer on real-world data: can we reduce dose to lymph node levels?Radiation oncology (London, England) · 2023Article
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Authors and funding
9 authors.
Funding
Abstract
purposeTo present the long-term and final report of a phase 3 trial designed to assess dose-response relationship for postoperative radiation therapy (PORT) and pathologic risk groups in head and neck cancer. METHODS AND MATERIALS: Patients who underwent primary surgery for American Joint Committee on Cancer stage III or IV squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx and who required PORT were eligible. Patients' primary sites and involved necks were independently assigned to higher- or lower-risk categories based on a cumulative point score representing increasing risk of recurrence. The sites in the lower-risk group were randomized to receive 57.6 or 63 Gy and those in the higher-risk group were randomized to receive 63 or 68.4 Gy, all at 1.8 Gy per fraction.
resultsA total of 264 patients were included. The actuarial 5-year locoregional control rate was 67%. A second primary cancer was documented in 27% of patients. The 5- and 10-year freedom-from-distant metastasis rates were 64% and 60%, respectively, whereas the 5- and 10-year overall survival rates were 32% and 20%, respectively. There was no statistically significant difference in tumor control between different dose levels in both the lower- and higher-risk groups. On multivariate analysis, nonwhite race (P=.0003), positive surgical margins (P=.009), extracapsular extension (ECE, P=.01), and treatment package time (TPT) ≥85 days (P=.002) were independent correlates of worse locoregional control, whereas age ≥57 years (P<.0001), positive surgical margins (P=.01), ECE (P=.026), and TPT ≥85 days (P=.003) were independently associated with worse overall survival.
conclusionsThis long-term report of PORT delivered at 1.8 Gy/d to total doses of 57.6 to 68.4 Gy without chemotherapy for head and neck squamous cell carcinoma demonstrated that increasing dose did not significantly improve tumor control. On multivariate analysis, the only significant treatment variable was TPT. The results confirm that positive surgical margins and/or nodal ECE remains the most significant predictive pathologic factors.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.