Experience Counts With Radiation Therapy for Head and Neck Cancer

Evan Wuthrick and Maura Gillison

When it comes to specialized cancer surgery, it’s generally true that the more experienced the surgeon, the better the outcome. The same might be true for radiation therapy used to treat head and neck cancer, according to a study by researchers at the OSUCCC – James.

The study was co-led by Evan Wuthrick, MD, assistant professor of Radiation Oncology at Ohio State, and Maura Gillison, MD, PhD, professor of Internal Medicine and Epidemiology at Ohio State, where she also is a member of the Cancer Control Program at the OSUCCC – James.

The study compared survival and other outcomes in 470 patients treated with radiation therapy at 101 treatment centers through a clinical trial held from 2002 to 2005. The trial was sponsored by the National Cancer Institute and organized by the Radiation Therapy Oncology Group (RTOG). The findings indicated that patients treated at the less experienced centers were more likely to have cancer recurrence (62 percent versus 42 percent at five years) and had poorer overall survival compared with those at the highly experienced centers (51 percent versus 69 percent five-year survival, respectively).

“Our findings suggest that institutional experience strongly influences outcomes in patients treated with radiation therapy for head and neck cancer,” says Wuthrick, the paper’s first author. “They indicate that patients do better when treated at centers where more of these procedures are performed versus centers that do fewer.”

Radiation therapy for head and neck cancer requires complex treatment planning that can vary considerably among institutions and physicians. In addition, significant short- and long-term side effects can occur that require management by a carefully coordinated multidisciplinary care team.

National Comprehensive Cancer Network guidelines recommend that head and neck cancer patients receive treatment at experienced centers, but whether provider experience affects outcomes was previously unknown.

Published in the Journal of Clinical Oncology