Pierfrancesco Franco1, Ilenia Potenza2, Marina Schena3, Giuseppe Riva4, Giancarlo Pecorari4, Paolo Garzino Demo5, Massimo Fasolis5, Francesco Moretto6, Massimiliano Garzaro4, Jacopo Di Muzio2, Marco Melano2, Mario Airoldi7, Riccardo Ragona2, Monica Rampino6, Umberto Ricardi2. 1. Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy pierfrancesco.franco@unito.it. 2. Department of Oncology, Radiation Oncology, University of Turin, Turin, Italy. 3. Department of Oncology, 1st Medical Oncology Division, AOU Città della Salute e della Scienza, Turin, Italy. 4. Department of Surgical Sciences, 1st ENT Division, University of Turin, Turin, Italy. 5. Department of Surgical Sciences, Maxillofacial Surgery Division, University of Turin, Turin, Italy. 6. Department of Medical Imaging and Radiotherapy, AOU Città della Salute e della Scienza, Turin, Italy. 7. Department of Oncology, 2nd Medical Oncology Division, AOU Città della Salute e della Scienza, Turin, Italy.
Abstract
AIM: The purpose of the study was to assess outcomes of locally advanced head and neck (LAHNC) treated with induction chemotherapy (ICT) and subsequent concurrent chemo-radiation. PATIENTS AND METHODS: A total of 71 LAHNC patients were treated with 2-3 cycles of docetaxel, cisplatin and 5-fluorouracil as induction chemotherapy and subsequent concurrent chemoradiation with weekly cisplatin or carboplatin. Definitive radiotherapy was delivered with intensity-modulated radiation and a simultaneous integrated boost approach up to a total dose of 70 Gy in 35 fractions to the macroscopic primary and nodal disease. RESULTS: Actuarial 2-year OS, CSS, DFS, MFS, LC were 55.3% (95%CI=39.3-68.6), 58.6% (95%CI=41.9-72), 60.5% (95%CI=47.3-71.4), 87.3% (95%CI=76.2-93.5) and 74.7% (95%CI=61.5-83.9), respectively. On multivariate analysis undergoing to 3 vs. 2 cycles of TPF (HR=22.31; 95%CI=2.68-185.66; p=0.004) and radiotherapy treatment break >4 days (HR=1.28; 95%CI=1.06-1.55; p=0.01) negatively affected cancer-specific survival (CSS) with statistical significance. Achieving complete remission after ICT had a statistically significant impact on CSS (HR=0.9; 95%CI=0.01-0.54; p=0.009). Patients undergoing ICT with 3 cycles had more frequently treatment breaks compared to those submitted to 2 cycles (HR=1.36; 95%CI=1.06-1.73; p=0.01), and had statistically significant longer treatment break time (5.9+1.8 vs. 3+0.36; p=0.02). CONCLUSION: A shorter ICT phase may be a better option enhancing patients' tolerance during concurrent chemoradiation and affecting clinical outcomes. Copyright
AIM: The purpose of the study was to assess outcomes of locally advanced head and neck (LAHNC) treated with induction chemotherapy (ICT) and subsequent concurrent chemo-radiation. PATIENTS AND METHODS: A total of 71 LAHNC patients were treated with 2-3 cycles of docetaxel, cisplatin and 5-fluorouracil as induction chemotherapy and subsequent concurrent chemoradiation with weekly cisplatin or carboplatin. Definitive radiotherapy was delivered with intensity-modulated radiation and a simultaneous integrated boost approach up to a total dose of 70 Gy in 35 fractions to the macroscopic primary and nodal disease. RESULTS: Actuarial 2-year OS, CSS, DFS, MFS, LC were 55.3% (95%CI=39.3-68.6), 58.6% (95%CI=41.9-72), 60.5% (95%CI=47.3-71.4), 87.3% (95%CI=76.2-93.5) and 74.7% (95%CI=61.5-83.9), respectively. On multivariate analysis undergoing to 3 vs. 2 cycles of TPF (HR=22.31; 95%CI=2.68-185.66; p=0.004) and radiotherapy treatment break >4 days (HR=1.28; 95%CI=1.06-1.55; p=0.01) negatively affected cancer-specific survival (CSS) with statistical significance. Achieving complete remission after ICT had a statistically significant impact on CSS (HR=0.9; 95%CI=0.01-0.54; p=0.009). Patients undergoing ICT with 3 cycles had more frequently treatment breaks compared to those submitted to 2 cycles (HR=1.36; 95%CI=1.06-1.73; p=0.01), and had statistically significant longer treatment break time (5.9+1.8 vs. 3+0.36; p=0.02). CONCLUSION: A shorter ICT phase may be a better option enhancing patients' tolerance during concurrent chemoradiation and affecting clinical outcomes. Copyright
Authors: Susanne M Arnold; Mahesh Kudrimoti; Emily V Dressler; John F Gleason; Natalie L Silver; William F Regine; Joseph Valentino Journal: Adv Radiat Oncol Date: 2016-07-14
Authors: S Mollnar; P Pondorfer; A-K Kasparek; S Reinisch; F Moik; M Stotz; M Halm; J Szkandera; A Terbuch; F Eisner; A Gerger; K S Kapp; R Partl; S Vasicek; T Weiland; M Pichler; H Stöger; D Thurnher; F Posch Journal: Clin Transl Oncol Date: 2020-07-15 Impact factor: 3.405