Outcomes following radiation for cutaneous squamous cell carcinoma of the head and neck: Associations between immune suppression and recurrence

Head Neck. 2019 Jul;41(7):2111-2115. doi: 10.1002/hed.25663. Epub 2019 Jan 29.

Abstract

Background: Data evaluating outcomes and patterns of recurrence following radiation therapy (RT) for cutaneous squamous cell carcinoma (cSCC) of the head and neck are limited.

Methods: We performed a retrospective analysis of 111 head and neck cSCC patients treated with RT at 4 affiliated institutions.

Results: With median follow-up of 7 months, there were 29 (26%) recurrences, 73% of which were nodal (n = 21). Immunosuppression (IS) was the only factor associated with recurrence (47% in IS, 22% in non-IS, P = .04), and also with time to recurrence in multivariate analysis (HR 5.5; P = .03). No factors were associated with recurrence among patients who received definitive RT. The majority of patients who recurred were salvaged with surgery (n = 20, 69%).

Conclusion: In a cohort of cSCC treated with radiotherapy, there was an association between IS and increased failure risk. The majority of failures were salvaged surgically.

Keywords: cSCC; immunosuppression; outcome; radiation; recurrence.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Squamous Cell / pathology
  • Carcinoma, Squamous Cell / therapy*
  • Female
  • Follow-Up Studies
  • HIV Infections / complications
  • Hematologic Neoplasms / complications
  • Humans
  • Immunocompromised Host*
  • Immunologic Factors / adverse effects
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neoplasm Recurrence, Local*
  • Radiotherapy Dosage
  • Radiotherapy, Adjuvant
  • Retrospective Studies
  • Skin Neoplasms / pathology
  • Skin Neoplasms / therapy*
  • Transplant Recipients

Substances

  • Immunologic Factors