Up-front neck dissection followed by definitive (chemo)-radiotherapy in head and neck squamous cell carcinoma: Rationale, complications, toxicity rates, and oncological outcomes - A systematic review.

Eliçin, Olgun; Nisa Hernandez, Lluis; Dal Pra, Alan; Bojaxhiu, Beat; Caversaccio, Marco; Schmücking, Michael; Aebersold, Daniel; Giger, Roland (2016). Up-front neck dissection followed by definitive (chemo)-radiotherapy in head and neck squamous cell carcinoma: Rationale, complications, toxicity rates, and oncological outcomes - A systematic review. Radiotherapy and oncology, 119(2), pp. 185-193. Elsevier 10.1016/j.radonc.2016.03.003

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BACKGROUND AND PURPOSE Lymph node metastases of head and neck cancer are considered one of the most negative prognostic factors. While outcomes and feasibility of chemo-radiotherapy ((C)RT) with or without adjuvant planned neck dissection (ND) in organ-preservation treatment strategy have been addressed, the role of ND before (C)RT, called up-front neck dissection (UFND), is not clearly established. This review provides a critical appraisal of UFND. MATERIAL AND METHODS Articles were identified with a systematic approach. Outcomes included post-UFND delay of (C)RT, surgical complications, radiation toxicity and oncologic outcome. RESULTS Fifteen studies met inclusion criteria, totaling 607 patients undergoing UFND. Part of the data suggest advantages toward less surgical complications compared with salvage ND, decreased serious acute radiation toxicity and better oncological outcomes when compared with (C)RT alone. The overall heterogeneity of the analyzed data does not allow a meta-analysis that provides high-quality evidence in favor or against UFND. CONCLUSIONS Due to lack of well-designed randomized trials, it is difficult to assess the role of UFND in organ-preserving (C)RT setting of head and neck cancer.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Ear, Nose and Throat Disorders (ENT)
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology

UniBE Contributor:

Eliçin, Olgun; Nisa Hernandez, Lluis; Dal Pra, Alan; Bojaxhiu, Beat; Caversaccio, Marco; Schmücking, Michael; Aebersold, Daniel and Giger, Roland

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0167-8140

Publisher:

Elsevier

Language:

English

Submitter:

Beatrice Scheidegger

Date Deposited:

11 Apr 2017 09:04

Last Modified:

30 Sep 2017 11:14

Publisher DOI:

10.1016/j.radonc.2016.03.003

PubMed ID:

26996775

Uncontrolled Keywords:

Head and neck; Neck dissection; Radiotherapy; Squamous cell carcinoma; Up-front

BORIS DOI:

10.7892/boris.92819

URI:

https://boris.unibe.ch/id/eprint/92819

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