To analyze the response of neck disease to treatment with primary chemoradiation.
Retrospective review of patients with head and neck cancer treated with chemoradiation with curative intent at a Veterans hospital.
Thirty-four patients were identified who received concomitant chemotherapy and radiation: 7 patients with N1, 22 with N2, and 7 with N3 disease. 78% of patients had complete clinical and radiographic response of their neck disease following treatment. Eleven patients underwent neck dissection post treatment. 33% of the neck specimens had pathologically positive nodes. 81% of patients were alive without evidence of recurrent disease in the primary site or neck at last follow up.
The majority of HNSCC patients treated with chemoradiation have complete response in the neck. Patients with clinical and radiographic evidence of complete response in the neck may not require neck dissection, even with N2 or greater disease.