Adding chemotherapy to adjuvant radiation therapy does not improve survival in patients with HPV-negative head and neck cancer squamous cell carcinoma (HNSCC) with extranodal extension (ENE) in a single lymph node JAMA Otolaryngology-Head & Neck Surgery.
The retrospective cohort study included 504 patients with pN2a HPV-negative HNSCC with ENE who had undergone margin-negative surgery and adjuvant therapy. Of the 504 participants, 298 (59.1%) received adjuvant chemoradiation therapy (CRT).
For the overall cohort of patients with pN2a ENE, adjuvant CRT was not associated with improved overall survival relative to adjuvant radiotherapy alone (adjusted hazard ratio [aHR] 0.98; 95% CI 0.74-1.30). Adjuvant CRT was still not associated with improved overall survival in a subset analysis of 304 patients aged
The authors concluded that adding chemotherapy concurrent with adjuvant radiation therapy was not associated with improved overall survival. They say additional research is necessary to identify the optimal treatment paradigm for this clinical scenario.