{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:44:17Z","timestamp":1786977857326,"version":"build-2736575974"},"reference-count":36,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T00:00:00Z","timestamp":1689292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perineural invasion (PNI) in head and neck squamous cell carcinoma (HNSCC) portends poor prognosis. Extent of treatment of nerve pathways with varying degrees of PNI and patterns of failure following elective neural radiotherapy (RT) remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective review of HNSCC patients with high\u2010risk (clinical\/gross, large\u2010nerve, extensive) or low\u2010risk (microscopic\/focal) PNI who underwent curative\u2010intent treatment from 2010 to 2021.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Forty\u2010four patients (mean follow\u2010up 22\u2009months; 59% high\u2010risk, 41% low\u2010risk PNI) were included. Recurrence following definitive treatment occurred in 31% high\u2010risk and 17% low\u2010risk PNI patients. Among high\u2010risk patients, 69% underwent surgery with post\u2010operative RT and 46% underwent elective neural RT. Local control (83% low\u2010risk vs. 75% high\u2010risk), disease\u2010free, and overall survival did not differ between groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High local control rates were achieved in high\u2010risk PNI patients treated with adjuvant or primary RT, including treatment of both involved and uninvolved, communicating cranial nerves, with few failures in electively treated regions.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/hed.27458","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T03:15:52Z","timestamp":1689304552000},"page":"2323-2334","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Radiation therapy for low\u2010 and high\u2010risk perineural invasion in head and neck cutaneous squamous cell carcinoma: Clinical outcomes and patterns of failure"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4313-3204","authenticated-orcid":false,"given":"Theodore A.","family":"Gobillot","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Greer","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Upendra","family":"Parvathaneni","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jay J.","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George E.","family":"Laramore","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Goff","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent","family":"Wallner","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3568-2630","authenticated-orcid":false,"given":"Cristina P.","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey J.","family":"Houlton","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany R.","family":"Barber","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neal D.","family":"Futran","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Washington  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2070-2005","authenticated-orcid":false,"given":"Zain H.","family":"Rizvi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head &amp; Neck Surgery University of Washington  Seattle Washington USA"},{"name":"Puget Sound Health Care System Department of Veterans Affairs  Seattle Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,7,14]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"NCCN.National Comprehensive Cancer Network clinical practice guidelines in oncology: squamous cell skin cancer version 1.2022; 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