The long-term survival of head and neck cancer patients treated with radiotherapy alone is poor, with local control rates of only 50% over 5 years and little impact on overall survival (OS). PORT (postoperative radiotherapy) should be given to patients with macroscopic residuals after surgery and is associated with an improvement in local control and survival. Patients with medically inoperable N1-2 disease, with severe comorbidities or who are poor surgical candidates can be managed by PORT. These patients can have RT alone with a boost to the cervical lymphatics. Superiorly when possible, it is recommended that adjuvant PORT be given to these patients.
The biochemical marker CA-125, originally reported by Helal in 1991, is a glycoprotein also called MUC16, a mucin that is overexpressed in various epithelial cancers and in particular ovarian, lung, and breast cancers. CA-125 is expressed by ovarian medullary cells of normal adults and is present in most patients with ovarian cancer. CA-125 increases in the serum weeks to months before clinical symptoms appear. The preoperative serum CA-125 measurement is used as a risk to predict histologic type and stage, as well as postoperative residual disease as long as 4 weeks to a year after surgery. Serum CA-125 may also be an early sentinel for chemotherapy-induced response. 7211a4ac4a