Document Type: Research Articles
Division of Medical Oncology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background: Non-squamous cell carcinoma of the head and neck (HNnSCCA) is a rare tumor. Surgery is the
standard treatment for resectable non-metastatic patients. Post-operative radiation (RT) is indicated for high-risk patients.
No data from the randomized controlled trial utilizing post-operative concurrent chemoradiation (CCRT) is available.
This study was aimed to determine the benefit of post-operative CCRT in the patients with resectable non-metastatic
HNnSCCA. Methods: We retrospectively reviewed data of 139 patients with HNnSCCA (excluding nasopharyngeal,
neuroendocrine, and skin cancers) who underwent surgery and post-operative radiation (RT) at Siriraj Hospital from
2009–2015. Results: Ninety-nine of the 139 patients had RT alone and 40 had CCRT. More patients receiving CCRT
had ≥ one high-risk feature (80% CCRT vs. 57.6% RT; p=0.018). Five-year disease-free survival (DFS) and overall
survival (OS) did not differ between the groups (58.6% CCRT vs. 68.2% RT; p=0.35 and 81.7% CCRT vs. 81.0% RT;
p=0.35, respectively). Interestingly, post-operative CCRT was independently associated with significantly superior
DFS (hazard ratio, HR 0.29; 95% confidence interval, CI 0.10 to 0.86; p=0.02) and OS (HR 0.08; 95% CI 0.01 to 0.43;
p=0.003) according to multivariable analyses. Conclusion: Post-operative CCRT was associated with better survival in
high-risk patients with resectable non-metastatic HNnSCCA comparing with post-operative RT alone. Post-operative
CCRT might be considered as a treatment option for these patients.