Recurrence patterns of locally advanced head and neck squamous cell carcinoma after 3D conformal (chemo)-radiotherapy

Didem C Oksuz, Robin J Prestwich, Brendan Carey, Stuart Wilson, Mustafa S Senocak, Ananya Choudhury, Karen Dyker, Catherine Coyle, Mehmet Sen

    Research output: Contribution to journalArticlepeer-review


    BACKGROUND: To establish recurrence patterns among locally advanced head and neck non-nasopharyngeal squamous cell carcinoma (HNSCC) patients treated with radical (chemo-) radiotherapy and to correlate the sites of loco-regional recurrence with radiotherapy doses and target volumes

    METHOD: 151 locally advanced HNSCC patients were treated between 2004-2005 using radical three-dimensional conformal radiotherapy. Patients with prior surgery to the primary tumour site were excluded. The sites of locoregional relapses were correlated with radiotherapy plans by the radiologist and a planning dosimetrist.

    RESULTS: Median age was 59 years (range:34-89). 35 patients had stage III disease, 116 patients had stage IV A/B. 36 patients were treated with radiotherapy alone, 42 with induction chemotherapy, 63 with induction and concomitant chemoradiotherapy and 10 concomitant chemoradiotherapy. Median follow-up was 38 months (range 3-62). 3-year cause specific survival was 66.8%. 125 of 151 (82.8%) achieved a complete response to treatment. Amongst these 125 there were 20 local-regional recurrence, comprising 8 local, 5 regional and 7 simultaneous local and regional; synchronous distant metastases occurred in 7 of the 20. 9 patients developed distant metastases in the absence of locoregional failure. For the 14 local recurrences with planning data available, 12 were in-field, 1 was marginal, and 1 was out-of-field. Of the 11 regional failures with planning data available, 7 were in-field, 1 was marginal and 3 were out-of-field recurrences.

    CONCLUSION: The majority of failures following non-surgical treatment for locally advanced HNSCC were loco-regional, within the radiotherapy target volume. Improving locoregional control remains a high priority.

    Original languageEnglish
    Pages (from-to)54
    JournalRadiation Oncology
    Publication statusPublished - 24 May 2011


    • Adult
    • Aged
    • Aged, 80 and over
    • Carcinoma, Squamous Cell/drug therapy
    • Combined Modality Therapy/methods
    • Female
    • Head and Neck Neoplasms/drug therapy
    • Humans
    • Imaging, Three-Dimensional/methods
    • Male
    • Middle Aged
    • Nasopharyngeal Neoplasms/drug therapy
    • Neoplasm Recurrence, Local
    • Radiotherapy, Conformal/methods
    • Recurrence
    • Treatment Outcome


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