NOTE

🌱 created from: head_and_neck_squamous_cell_cancer

treatment–curative-hnscc

RTOG 0522

• Early-stage: Surgery or RT alone
• Locally advanced: Surgery followed by adj. RT (± chemo for high-risk features) or upfront concurrent CRT (see CRT below) with surgery reserved for salvage
• No OS benefit to adj. chemo alone (MACH-NC, Radiother Oncol 2009;92:4)
• RT—when surgery is not technically feasible or undesirable (eg, larynx preservation). SEs of RT—both short- & long-term fatigue, mucositis, xerostomia, dermatitis, rarely 2° malignancies (sarcomas). IMRT standard 66–70-Gy, 2-Gy fractions to 1° tumor &/or side of neck with LNs. “Hyperfractionation” = potential higher cumulative doses in smaller fractions

KEYNOTE-689