RESUMO
BACKGROUND: Data evaluating outcomes and patterns of recurrence following radiation therapy (RT) for cutaneous squamous cell carcinoma (cSCC) of the head and neck are limited. METHODS: We performed a retrospective analysis of 111 head and neck cSCC patients treated with RT at 4 affiliated institutions. RESULTS: With median follow-up of 7 months, there were 29 (26%) recurrences, 73% of which were nodal (n = 21). Immunosuppression (IS) was the only factor associated with recurrence (47% in IS, 22% in non-IS, P = .04), and also with time to recurrence in multivariate analysis (HR 5.5; P = .03). No factors were associated with recurrence among patients who received definitive RT. The majority of patients who recurred were salvaged with surgery (n = 20, 69%). CONCLUSION: In a cohort of cSCC treated with radiotherapy, there was an association between IS and increased failure risk. The majority of failures were salvaged surgically.
Assuntos
Carcinoma de Células Escamosas/terapia , Hospedeiro Imunocomprometido , Recidiva Local de Neoplasia , Neoplasias Cutâneas/terapia , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Feminino , Seguimentos , Infecções por HIV/complicações , Neoplasias Hematológicas/complicações , Humanos , Fatores Imunológicos/efeitos adversos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Dosagem Radioterapêutica , Radioterapia Adjuvante , Estudos Retrospectivos , Neoplasias Cutâneas/patologia , TransplantadosRESUMO
BACKGROUND: Departmental "chart rounds" is an established form of review in radiation oncology, however, evidence is lacking that identifies links between features of a more subspecialized disease site-specific review and the likelihood and characteristics of recommendations made. We prospectively analyzed our head and neck group's review process to identify associations that could guide future practice. METHODS: Our group reviewed proposed management and treatment volumes for radiation simulated patients on a weekly basis, and we collected data encompassing recommendations made by individuals or group consensus. RESULTS: Changes in management, prescribed dose, radiation fractionation, clinical target volumes, or target contours were suggested in 85 of 182 cases. The most frequently recommended changes were adjustment of regions treated or target contours, and an inverse correlation was observed between the number of attending physicians present and specific changes suggested to the gross tumor volume (GTV). CONCLUSION: We find that site-specific head and neck peer review results in frequent recommendations largely independent of the type of case reviewed.