Abstract
BACKGROUND: Reducing elective nodal irradiation dose can decrease treatment toxicity and improve quality of life for head and neck cancer patients. METHODS: We determined the effectiveness of reducing elective radiotherapy doses to 40 Gy for a consecutive cohort of laryngeal, hypopharyngeal, and p16-negative oropharyngeal or unknown primary squamous cell carcinomas treated with concurrent chemoradiation. The primary outcome measure was solitary elective nodal recurrence. RESULTS: The cohort included 73 consecutive patients with a median follow up of 23.3 months. There were no cases of solitary elective nodal recurrence. Six patients had locoregional recurrence, eight had distant recurrence, and two had simultaneous locoregional and distant recurrence. All locoregional recurrences occured in the 70 Gy target volume (three in the primary tumor target, three in the involved node target, and two in both). CONCLUSIONS: Reduction in elective nodal radiation dose did not lead to solitary elective nodal recurrences for laryngeal, hypopharyngeal, and p16-negative oropharyngeal cancers.