Evidence map›Paper›PMID 38778826›Full record

ArticleAdvances in radiation oncology2024

Adjuvant Reirradiation With Proton Therapy in Head and Neck Squamous Cell Carcinoma.

Kristin Hsieh, Alexandra Elena Hotca, Daniel R Dickstein, Eric J Lehrer, Celina Hsieh, Vishal Gupta, Kunal K Sindhu, Jerry T Liu, Samuel H Reed, Arpit Chhabra and 8 more

Abstract read
In one paragraph

Article in Advances in radiation oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Prospects and Disadvantages of Intraoperative Radiotherapy: A Systematic Review.Asian Pacific journal of cancer prevention : APJCP · 2025
    Pooled it
  2. Head and neck squamous cell carcinoma: current and emerging therapeutic strategies.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
  3. Review
  4. Gender parity in radiation oncology in Germany: a 2024 analysis of professional roles and academic training.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2026
    Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors.

Kristin HsiehDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Alexandra Elena HotcaDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Daniel R DicksteinDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Eric J LehrerDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Celina HsiehDepartment of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Vishal GuptaDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Kunal K SindhuDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Jerry T LiuDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Samuel H ReedDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Arpit ChhabraNew York Proton Center, New York, New York.
Krzysztof MisiukiewiczDepartment of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Scott RoofDepartment of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Mohemmed Nazir KahnDepartment of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Diana KirkeDepartment of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Mark UrkenDepartment of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Marshall PosnerDepartment of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.
Eric GendenDepartment of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, New York.
Richard L BakstDepartment of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, New York.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: For patients with head and neck squamous cell carcinoma (HNSCC), locoregional failure and second primary tumors are common indications for adjuvant reirradiation (re-RT). Given an absence of clear consensus on the role of adjuvant re-RT, we sought to assess histopathologic risk factors of patients with HNSCC and their resulting outcomes after adjuvant re-RT with proton therapy. Methods and Materials: We conducted a retrospective analysis of patients with HNSCC who underwent salvage surgery at our institution followed by adjuvant re-RT with proton therapy over 1.5 years. All included patients received prior radiation therapy. The Kaplan-Meier method was used to evaluate locoregional recurrence-free survival and overall survival. Results: The cohort included 22 patients, with disease subsites, including oropharynx, oral cavity, hypopharynx, larynx, and nasopharynx. Depending on adverse pathologic features, adjuvant re-RT to 66 Gy (32% of cohort) or 60 Gy (68%), with (59%) or without (41%) concurrent systemic therapy was administered. The majority (86%) completed re-RT with no reported treatment delay; 3 patients experienced grade ≥3 acute Common Terminology Criteria for Adverse Events toxicity and no patient required enteral feeding tube placement during re-RT. Median follow-up was 21.0 months (IQR, 11.7-25.2 months). Five patients had biopsy-proven disease recurrences a median of 5.9 months (IQR, 3.8-9.7 months) after re-RT. Locoregional recurrence-free survival was 95.2%, 70.2%, 64.8% at 6, 12, and 24 months, respectively. OS was 100%, 79.2%, and 79.2% at 6, 12, and 24 months, respectively. Four patients had osteoradionecrosis on imaging a median of 13.2 months (IQR, 8.7-17.4 months) after re-RT, with 2 requiring surgical intervention. Conclusions: Adjuvant re-RT for patients with HNSCC was well-tolerated and offered reasonable local control in this high-risk cohort but appears to be associated with a risk of osteoradionecrosis. Additional study and longer follow-up could help define optimal patient management in this patient population.

Identifiers

PMID38778826
PMCPMC11110036

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Registered trials

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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.