Chia-Lun Chang1, Kevin Sheng-Po Yuan2, Szu-Yuan Wu3,4,5,6. 1. Department of Hemato-Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 2. Department of Otorhinolaryngology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 3. Institute of Toxicology, College of Medicine, National Taiwan University, Taipei, Taiwan. 4. Department of Radiation Oncology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan. 5. Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan. 6. Department of Biotechnology, Hungkuang University, Taichung, Taiwan.
Abstract
BACKGROUND: No randomized studies have compared low-dose or high-dose concurrent chemoradiotherapy (CRT). METHODS: In this study, 7219 patients with stage III or IV head and neck squamous cell carcinoma (HNSCC) were enrolled and categorized into 2 groups: group 1, comprising those undergoing low-dose concurrent CRT (n = 1575), and group 2, comprising those receiving high-dose concurrent CRT (n = 5644). RESULTS: Cox regression analyses revealed that age ≥65 years, male, high Charlson comorbidity index (CCI) scores, radiotherapy (RT) duration ≥7.5 weeks, clinical stage IV cancer, oral cavity cancers, tobacco smoking, and total cisplatin dose ≥240 mg/m2 were significant independent prognostic risk factors for overall survival (OS). After adjustment for confounders, the adjusted hazard ratio (aHR; 95% confidence interval [CI]) for overall mortality was 0.83 (0.78-0.89; P < .001) in patients with oral cavity HNSCC undergoing high-dose concurrent CRT and 0.82 (0.77-0.94; P < .001) in patients with nonoral cavity HNSCC receiving high-dose concurrent CRT. CONCLUSION: High-dose concurrent CRT can reduce the incidence of death in patients with stage III or IV HNSCC.
BACKGROUND: No randomized studies have compared low-dose or high-dose concurrent chemoradiotherapy (CRT). METHODS: In this study, 7219 patients with stage III or IV head and neck squamous cell carcinoma (HNSCC) were enrolled and categorized into 2 groups: group 1, comprising those undergoing low-dose concurrent CRT (n = 1575), and group 2, comprising those receiving high-dose concurrent CRT (n = 5644). RESULTS: Cox regression analyses revealed that age ≥65 years, male, high Charlson comorbidity index (CCI) scores, radiotherapy (RT) duration ≥7.5 weeks, clinical stage IV cancer, oral cavity cancers, tobacco smoking, and total cisplatin dose ≥240 mg/m2 were significant independent prognostic risk factors for overall survival (OS). After adjustment for confounders, the adjusted hazard ratio (aHR; 95% confidence interval [CI]) for overall mortality was 0.83 (0.78-0.89; P < .001) in patients with oral cavity HNSCC undergoing high-dose concurrent CRT and 0.82 (0.77-0.94; P < .001) in patients with nonoral cavity HNSCC receiving high-dose concurrent CRT. CONCLUSION: High-dose concurrent CRT can reduce the incidence of death in patients with stage III or IV HNSCC.
Authors: Ambika Parmar; Michaelina Macluskey; Niall Mc Goldrick; David I Conway; Anne-Marie Glenny; Janet E Clarkson; Helen V Worthington; Kelvin Kw Chan Journal: Cochrane Database Syst Rev Date: 2021-12-20
Authors: Muhammad Furqan; Travis P Snyders; Mohammed U Saqlain; Sarah L Mott; Douglas Laux; Anthony Snow; Carryn M Anderson; John M Watkins; Gerald H Clamon Journal: Cancer Med Date: 2019-04-09 Impact factor: 4.452
Authors: Lei Qin; Yi-Wei Kao; Yueh-Lung Lin; Bou-Yue Peng; Win-Ping Deng; Tsung-Ming Chen; Kuan-Chou Lin; Kevin Sheng-Po Yuan; Alexander T H Wu; Ben-Chang Shia; Szu-Yuan Wu Journal: Cancer Med Date: 2018-07-15 Impact factor: 4.452