ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Post-Chemoradiation of Head and Neck Cancer: SND and Aspiration

by Jennifer Decker Arevalo, MA • October 1, 2007

  • Tweet
  • Email
Print-Friendly Version

The National Cancer Institute states that cancers of the head and neck account for 3% to 5% of all malignancies in the United States. Although this percentage may seem small, it still means that more than 55,000 Americans will develop cancer of the head and neck this year and nearly 13,000 of them will die from it, according to the American Academy of Otolaryngology-Head and Neck Surgery.

You Might Also Like

  • Chemoradiation vs. Surgery: Which is Better for Head and Neck Cancer?
  • Randomized Trial Shows No Benefit of Intra-Arterial Chemoradiation Delivery in Head and Neck Cancer
  • PET-Directed Management of Node-Positive Head and Neck Cancers
  • Pretreatment Swallowing Assessment in Head and Neck Cancer Patients
Explore This Issue
October 2007

Two scientific sessions at the April 2007 Combined Otolaryngology Spring Meeting focused on post-chemoradiation issues related to head and neck cancer. Adam S. Jacobson, MD, from the Department of Otolaryngology-Head and Neck Surgery at the Mount Sinai School of Medicine in New York and Alexander Langerman, MD, of the University of Chicago’s Department of Surgery, Section of Otolaryngology-Head and Neck Surgery, presented results from their studies titled, Efficacy of Selective Neck Dissection Following Adjuvant Radiation or Chemoradiation for Advanced Head and Neck Cancer and Aspiration in Chemoradiated Head and Neck Cancer Patients, respectively. Dr. Langerman’s paper has been accepted by the Archives of Otolaryngology-Head and Neck Surgery.

Selective Neck Dissection

Recent advances in medical therapy for cancers of the head and neck include combined chemoradiation and induction chemotherapy plus concomitant chemoradiation.1 Regional recurrence is common in patients with advanced nodal disease, and radical and modified radical neck dissections have long been the standard of care following primary chemoradiation.

However, there has been a gradual shift in the surgical management of advanced head and neck cancer toward selective neck dissection (SND)2,3,4 in patients with locoregionally advanced disease following definitive adjuvant therapy.5,6,7

There is an improved quality of life for patients who had SND following chemoradiation when compared to those patients who had a radical or modified radical neck dissection, said Dr. Jacobson.

Dr. Jacobson and his colleagues conducted a retrospective chart review of 58 patients with either stage III or IV squamous cell carcinoma of the upper aerodigestive tract with bulky nodal disease (N2, N3) to determine the efficacy of SND after primary radiation therapy or chemoradiation. The primary tumor sites included oropharynx (15/58), hypopharynx (12/58), pharynx (16/58), larynx (11/58), and unknown primary (4/58).

In his study, Dr. Jacobson stated that definitive treatment consisted of either concomitant chemoradiation (67.2%) or external beam radiation therapy (32.8%). In the monotherapy group, all patients received a total curative dose of 66 to 72 Gy in once-daily fractions of 180 to 200 cGy. The chemoradiation group received a similar radiation schedule and a four-day continuous infusion of cisplatin, 20 mg/m2/day and 5-fluorouracil, 1000 mg/m2/day. The infusions were given on the first and fourth weeks of radiotherapy. A planned selective neck dissection was performed on all the patients three to 12 weeks after completion of definitive medical therapy. CT scans of the neck were not routinely obtained prior to the staged neck dissection. All patients had a selective neck dissection encompassing levels II-IV. Following neck dissection, the median time of follow-up was 37 months (range 17-71 months).

Pages: 1 2 3 4 5 | Single Page

Filed Under: Head and Neck Issue: October 2007

You Might Also Like:

  • Chemoradiation vs. Surgery: Which is Better for Head and Neck Cancer?
  • Randomized Trial Shows No Benefit of Intra-Arterial Chemoradiation Delivery in Head and Neck Cancer
  • PET-Directed Management of Node-Positive Head and Neck Cancers
  • Pretreatment Swallowing Assessment in Head and Neck Cancer Patients

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Non-Acidic Reflux Explains Lack of Response to H2 Blockers and PPIs
    • Vertigo in the Elderly: What Does It Mean?
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Why Virtual Grand Rounds May Be Here to Stay
    • Otolaryngologist Leverages His Love of Pinball into Second Business
    • These New Imaging Advances May Help to Protect Parathyroids
    • Is the Training and Cost of a Fellowship Worth It? Here’s What Otolaryngologists Say
    • Which Otologic Procedures Poses the Greatest Risk of Aerosol Generation?

Polls

Have you used 3D-printed materials in your otolaryngology practice?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.