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Background: No risk‐stratification strategies exist for patients with recurrent oropharyngeal cancer (OPC). Methods: Retrospective analysis using data from prospective NRG Oncology clinical trials RTOG 0129 and 0522. Eligibility criteria included known p16 status and smoking history, and locoregional/distant recurrence. Overall survival (OS) was measured from date of recurrence. Recursive partitioning analysis was performed to produce mutually exclusive risk groups. Results: Hundred and fifty‐four patients were included with median follow‐up after recurrence of 3.9 years (range 0.04–9.0). The most important factors influencing survival were p16 status and type of recurrence, followed by surgical salvage and smoking history (≤20 vs. >20 pack‐years). Three significantly different risk groups were identified. Patients in the low‐, intermediate‐, and high‐risk groups had 2‐year OS after recurrence of 81.1% (95%CI 68.5–93.7), 50.2% (95%CI 36.0–64.5), and 20.8% (95%CI 10.5–31.1), respectively. Conclusion: Patient and tumor characteristics may be used to stratify patients into risk groups at the time of OPC recurrence. [ABSTRACT FROM AUTHOR]

Background: Process‐related measures have been proposed as quality metrics in head and neck cancer care. A recent single‐institution study identified four key metrics associated with increased survival. This study sought to validate the association of these quality metrics with survival in a multi‐institutional cohort. Methods: Multicenter retrospective study of patients with oral cavity squamous cell (1/2005‐1/2015). Baseline patient and disease characteristics and compliance with quality metrics was evaluated. Association between compliance with quality metrics with overall survival (OS), disease‐free survival (DFS), and disease‐specific survival (DSS) was evaluated using Cox proportional hazards models. Results: Failure to comply with two or more of the quality metrics was associated with worse OS, DFS, and DSS. Adherence to all or all but one of the quality metrics was found to be associated with improved survival. Conclusions: Process‐related quality metrics are associated with increased survival in patients with oral cavity squamous cell carcinoma in a multi‐institutional cohort. [ABSTRACT FROM AUTHOR]

Background: Radiotherapy (RT) is an integral component in the treatment of head and neck cancer (HNC).We hypothesized there would be alterations in gene‐expression and pathway activity in HNC samples obtained in recurrent HNC that were previously treated with RT, when compared to RT‐naïve disease. Methods: Patient data was abstracted from a prospectively maintained database. Linear‐microarray analysis and supervised gene‐set enrichment‐analysis were employed to compare RT‐naive and recurrent disease after prior‐RT. Results: A total of 157 patients were analyzed, 96 (61%) were RT‐naive and 61 (39%) had RT.After radiation, there was upregulation of genes associated with angiogenesis, protein‐translation‐machinery, cell‐cycle regulation, and growth factors, and downregulation associated with Myc activity, and hypoxic response (all P <.001).Previously irradiated HNC was associated with downregulation in 19/42 genes in the Wnt/B‐catenin‐pathway (P =.045)and 119/199 genes involved in the MYC target pathway (P =.024). Conclusion: Patients with recurrences salvaged surgically post‐RT had significant alterations in gene‐expression and in Wnt/B‐catenin and MYC‐target pathways. These pathways may represent potential targets to prevent development of resistance to RT. [ABSTRACT FROM AUTHOR]

The article reviews the book "Radiotherapy for Head & Neck Cancer: Indication & Techniques," by K. Kian Ang and Adam S. Garden.