Study (Data Aquired) — No. of Patients (Total No. In Study) | Radiotherapy (No.) RT dosage median (range) | Nodal State No.(%) | Invasive Diagnostics — Surgical Treatment before RT No.(%) | locoregional control — distant metastases (median time to appearance, months) | overall survival — Head and Neck Mucosal Emergence No.(%) [most common site] |
---|---|---|---|---|---|
Bataini et al., 1987 [9] (1960–1980) — 138 | dRT (90 pts): 70-80Gy pRT (48 pts): 50-60Gy bilateral 138, mucosa 43% | N1 45 (33) N2 32 (23) N3 60 (44) 137/138 EC 60%, UC 40% | FNAB/IB/EB 90 (65) — Adenectomy or RND 48 (35) | neck failure: definitive RT: 43% RND + RT: 17% ultimately — ultimately 25% | definitive RT: 22% RND + RT: 55% overall 33% at 5 years — 6 (4) [NR] |
Jesse et al., 1973 [10] (1948–1968) — RT alone: 52 (210) | dRT (52): 50-60Gy + 5-10Gy unilateral 0, bilateral + mucosa 52 | N1 12 (23) N2-3 23 (77) SCC 62%, UC 28%, GCSO 10% | EB 114/210 (52% total) — none in this group | initial local control 79% — NR | 48% at 3 years — 3 (6) [oral cavity] |
Weir et al., 1995 [11] (1970–1986) — 144 | involved neck (85pts), bilateral + mucosa (59pts): 25 pts: 35-49Gy, 86 pts: 50-59Gy, 33 pts: 60-70Gy | N1 11 (5) N2 67 (47) N3 55 (38) Nx 5 (3) 138/144 UC 30%, SCC 62%, others 8% | EB 71 (50), IB 62 (43) FNAB 7 (7) — none | initial local control 51% — ultimately 23% | involved neck 37%, bilateral + mucosa 48%, overall 41%, at 5 years — 7 (5) [oropharynx] |
Reddy et al., 1997 [12] (1974–1989) — 52 | dRT (21): involved neck 70Gy (66–76) pRT (31): involved neck 64Gy (60–66) dRT/pRT: mucosa 60-66Gy, contralateral neck 46-50Gy unilateral 16, bilateral + mucosa 36 | N1 9 (17) N2a 16 (31) N2b 7 (13) N2c 5 (10) N3 15 (29) | EB/IB 21 (40) — RND 31 (60) | NR — ultimately 15% | 40% at 5 years — 10 (19) [base of tongue] |
Colletier et al., 1998 [13] (1968–1992) — 136 | pRT (136): involved neck 63Gy (34-70) mucosa + uninvolved neck 50-54Gy unilateral 16, bilateral 120 | N1 31 (23) N2a 49 (37) N2b 25 (18) N2c 3 (2) N3 18 (13) Nx 10 (7) SCC 93%, NS 7% | EB 39 (29) — MND 64 (47) RND 33 (24) | 84% with ECE 100% without ECE neck control at 5 years — 15% at 5 years | 60% at 5 years 41% at 10 years — 14 (10) [oral cavity] |
Fernández et al., 1998 [14] (1976-1996) — 67 | dRT (3)/pRT (64): 50Gy bilateral + mucosa 67 | N1 9 (13) N2 33 (49) N3 25 (37) | FNAB 40 (60) — RND 50 (75) MND 14 (21) | 34% neck recurrence, mean 5 months — 22%, mean 17 months | 22% at 5 years 20% at 10 years — 10 (15) [oropharynx] |
Grau et al., 2000 [15] (1975-1995) — RT ± ND 250 (352) | dRT (250): neck 59Gy (28-93) neck + mucosa 66Gy (20-79) unilateral 26, bilateral + mucosa 224 | N1 37 (15) N2 119 (48) N3 93 (37) Nx 1 (.4) | FNAB (12) CB (1) EB/IB (85) — ND (2) | local control 44% neck control 51% muscosal control 81% — NR | 36% — 17 (7) [oropharynx] |
Iganej et al., 2002 [16] (1969-1994) — 106 | dRT: 66Gy (48-70) pRT: 60Gy (50-70) unilateral 16, bilateral + mucosa 163 | N1 14 (13) N2a 27 (25) N2b 39 (37) N2c 2 (2) N3 24 (23) | EB alone 12 EB + RT 15 — RND 29 RT alone 24 RND + RT 26 | 54% neck recurrence, median 7 months; ultimately 34% neck failure — 9% (4) | 53% at five years — 19 (18) [tonsil] |
Yalin et al., 2002 [17] (1976-1988) — 114 | UC: RT 50-70Gy SCC: RT 40-60Gy AC: 60Gy | N1 33 (29) N2 51 (45) N3 30 (26) UC 62%, SCC 24%, AC 14% | FNAB 111/EB 3 (100) — RND in case of bilateral disease (+thyrectomy in case of AC) | NR — NR | UC: 32%, SCC: 33% AC: 38% at 5 years — 12 (11) [tonsillar fossa] |
Aslani et al., 2007 [18] (1987-2002) — 61 | dRT (40): 64Gy (60-70) pRT (21): 60Gy (56-66) unilateral 11, bilateral 50 | N1 16 (26) N2a 18 (31) N2b 13 (21) N2c 7 (11) N3 7 (11) UC 15% | FNAB 9 (15) EB 32 (52) — MND 9 (15) RND 11 (18) | neck control: with biopsy 76%, ND 85% at 5 years; 73% at 8 years — 11.5% (2-24 months) | 79% at 5 years 67% at 8 years — 4 (7) [base of tongue] |
Boscolo-Rizzo et al., 2006 [19] (1980-2001) — 82 | dRT (32 pts), pRT (47 pts): 60-70Gy before 1989; 50Gy + 10-20Gy after 1989 unilateral 37, bilateral 42 | N1 10 (12) N2a 14 (17) N2b 23 (28) N2c 3 (4) N3 32 (39) | FNAB/EB 82 (100) — RND 46 (56) MND 4 (5) | NR — 23% at 10 years | 25% at 5 years 19% at 10 years — 10 (12) [base of tongue] |
Beldi et al., 2007 [20] (1980-2004) — 113 (22/113 palliative intent) | dRT (59), pRT (54): involved neck 50Gy*, 60Gy** bilateral neck + mucosa 50Gy*, 56Gy** unilateral 45, bilateral 67 | N1 21 (19) N2a 12 (11) N2b 42 (37) N2c 10 (9) N3 28 (25) SCC 77%, AC 5%, UC 10%, others 8% | FNAB 14 (12) EB 37 (33) — ND 62 (55) | disease free survival 27% at 5 years — NR | 41% at 5 years — 19 (17) [NR] |
Patel et al., 2007 [21] (1987-2006) — 70 | pRT (60 pts): 50Gy or 54-60Gy unilateral 49, bilateral 11 | N1 5 (7) N2a 13 (19) N2b 30 (43) N2c 4 (6) N3 18 (26) | FNAB 68 (97) EB 2 (3) — MND 70 (100) | ipsilateral control 84% contralateral control 93% at 5 years — 10% (9) | 56% at 5 years — 8 (11) [base of tongue] |
Corry et al., 2008 [22] (1998-2002) — | macroscopic disease 70Gy larger nodal masses 60Gy sites of suspected subclinical disease 50Gy | N2a 12 (12) N2b 43 (42) N2c 27 (26) N3 20 (20) | occult HNSCC\— ND 16 (16) | neck failure ultimately 9% — ultimately 23% | 60% at 3 years (of 122 pts) — |
Ligey et al., 2009 [29] (1990-2007) — 102 (122) | pRT (95): involved neck 66Gy mucosa + uninvolved neck 50Gy unilateral 59, bilateral 36 | N1 9 (9) N2a 22 (23) N2b 33 (35) N3 15 (16) Nx 16 (17) EC 100% | EB 16 (17) — RND/MND 79 (83) | neck control 66% at 5 years — ultimately 30% | 24% at 5 years — 9 (9) [tongue] |
Lu et al., 2009 [23] (1989-2003) — 60 | dRT (60): 69Gy (66-72) to mucosa; 62Gy (53-74) to involved areas; 51Gy (44-59) to uninvolved areas unilateral 25, bilateral 24, bilateral + mucosa 11 | N1 10 (17) N2 39 (65) N3 11 (18) | FNAB 51 (85) EB 9 (15) — none | neck control 66% at 5 years — ultimately 18% | 69% at 5 years — 10 (21) [nasopharynx] |
Chen et al., 2011 [24] (2001-2009) — 60 | dRT (15): involved neck 60-74Gy uninvolved neck 54-66Gy pRT (45): involved neck 63Gy (60-66) uninvolved neck 56Gy (54-60) bilateral + mucosa 60 | N1 5 (8) N2a 26 (43) N2b 20 (33) N2c 0 (0) N3 9 (15) | FNAB 15 (25) EB 5 (8) — ND 8 (13) MND 32 (53) | locoregional control 89% at 2 years — 13% (9) | 89% at 2 years — NR |
Wallace et al., 2011 [25] (1964-2006) — 179 | dRT (179): mucosa 57Gy (24-74) neck 65Gy (50-86) unilateral 5, bilateral + mucosa 174 | N1 18 (10) N2a 48 (27) N2b 46 (26) N2c 11 (6) N3 56 (31) | none — ND 65 (36) before RT ND 44 (25) after RT | mucosal control 92% and neck control 81% at 5 years — 14% at 5 years | 52% at 5 years — NR |
Fakhrian et al., 2012 [26] (1988-2009) — 65 | unilateral RT (17 pts): 60Gy (50-66) bilateral RT + mucosa (48 pts): 65Gy (28-70) | N1 14 (21) N2a 9 (14) N2b 34 (52) N2c 2 (3) N3 5 (8) UC 14% | EB 10 (15) — RND 27 (42) MND 24 (37) | locoregional lymph node recurrence, ultimately 14% — 28% (23) | 48% at 5 years — 10 (15) [nasopharynx] |
Tribius et al., 2012 [67] (2002-2011) — 63 | dRT (63): involved neck 60-68Gy mucosa 60 Gy uninvolved neck 50-54Gy unilateral 7, bilateral 47 | N1 6 (10) N2 38 (57) N3 19 (30) | FNAB 63 (100) — none | neck recurrence 25%, median 7 months — 13% (10) | 76% at 2 years — 4 (6) [base of tongue] |
Demiroz et al., 2014 [27] (1994-2009) — 41 | dRT (19 pts): involved neck 70Gy univovled neck 50-59Gy pRT (22 pts): formerly inv. neck 60Gy (ECE 66Gy) univolved neck 54Gy bilateral + mucosa 67 | N1 4 (10) N2a 10 (24) N2b 18 (44) N2c 0 (0) N3 9 (22) | FNAB/EB 41 (100) — RND 5 (12) MND 17 (41) | LRFS:dRT: 75% ND + RT: 76% at 4 years — definitve RT: 11% ND + RT: 28% ultimately | definitve RT: 85% ND + RT: 85% at 4 years — 2 (5) tonsillar fossa] |
Straetmans et al., 2015 [28] (1997-2010) — 51 | pRT (46 pts): univolved neck 50.4Gy or 46-50Gy involved neck 59.4-63Gy or 60-66Gy unilateral 32, bilateral 14 | N1 4 (9) N2a 7 (15) N2b 28 (52) N3 12 (24) | FNAB (22) — MND 51 (100) | neck recurrence ultimately 18% — ultimately 18% (<24) | 55% at 5 years — 0 |