6.9.13: 13. Indications for Postoperative (chemo)radiation Therapy

Atlas of Otolaryngology, Head and Neck Operative Surgery · LibreTexts

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    Oropharyngeal cancer: Indications for postoperative (chemo)radiation therapy

    Postoperative Radiotherapy

    • Ideally commenced within 6 weeks of surgery
    • Primary tumour bed
      • T3/4
      • Perineural invasion (PNI)
      • Positive / close margin
      • Intra-operative tumour spillage
      • Bone marrow invasion
      • Note: Lymphovascular invasion is more an indication of risk for spread to nodes rather than for recurrence and so it is not an indication on its own for adjuvant RT
    • Neck
      • >2 metastatic nodes
      • Extranodal extension (ENE)

    Postoperative Chemoradiation

    Indications

    • Positive margins
    • ENE

    Added expense and toxicity

    • Only 5% lifetime survival advantage with addition of chemotherapy to radiation therapy in an adjuvant setting
    • Therefore carefully consider indications especially in
      • Poor patient
      • Poor socioeconomic support
      • Poor general health
      • Elderly

    This page titled 6.9.13: 13. Indications for Postoperative (chemo)radiation Therapy was last modified on Sat, 11 Dec 2021 02:15:47 GMT and is shared under a CC BY-NC 3.0 license and was authored, remixed, and/or curated by Open Access Atlas of Otolaryngology, Head, and Neck Operative Surgery.