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ORIGINAL ARTICLE Postoperative Reirradiation for Mucosal Head and Neck Squamous Cell Carcinomas Tim A. Iseli, MBBS; Claire E. Iseli, MBBS, MS; Eben L. Rosenthal, MD; Jimmy J. Caudell, MD, PhD; Sharon A. Spencer, MD; J. Scott Magnuson, MD; Angelia N. Smith, BSc; William R. Carroll, MD Objectives: To compare toxic effects and functional out- without surgery, postoperative reirradiation was associ- comes of reirradiation with and without salvage surgery ated with increased early grade 3 to grade 5 toxic effects for nonnasopharyngeal mucosal head and neck squa- (50% [19 of 38] vs 29% [14 of 49], P=.04) and with longer mous cell carcinoma. median survival (17.3 vs 8.9 months, P.001). Free- flap reconstruction decreased early toxic effects in the Design: Retrospective review. surgical cohort by 16% (from 60% [9 of 15] to 43% [10 of 23], P=.32). Gastrostomy tube dependence (P=.05) Setting: Academic tertiary referral hospital. and tracheostomy retention (P=.04) have increased since 2000. The median survival for curative patients was 12.5 Patients: Between December 1992 and March 2007, a months. The estimated 2-year survival was 25%, and the total of 87 patients underwent reirradiation (64 for cure estimated 5-year survival was 8%. and 23 for palliation). Conclusions: Reirradiation represents
JAMA Otolaryngology - Head & Neck Surgery – American Medical Association
Published: Nov 1, 2009
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