6.9.13: 13. Indications for Postoperative (chemo)radiation Therapy
- Page ID
- 53890
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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