Carlos A Narvaez1, Steven E Schild2, Stefan Janssen1,3, Ursula Schroeder4, Karl L Bruchhage4, Samer G Hakim5, Dirk Rades6. 1. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany. 2. Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ, U.S.A. 3. Private Practice of Radiation Oncology, Hannover, Germany. 4. Department of Oto-Rhino-Laryngology and Head and Neck Surgery, and Oral, University of Lübeck, Lübeck, Germany. 5. Maxillofacial Surgery, University of Lübeck, Lübeck, Germany. 6. Department of Radiation Oncology, University of Lübeck, Lübeck, Germany; rades.dirk@gmx.net.
Abstract
BACKGROUND/AIM: Patients with unresectable head-and-neck cancer (SCCHN) unable to tolerate radiochemotherapy may receive unconventionally fractionated radiotherapy. This retrospective study compared both treatments. PATIENTS AND METHODS: Eight patients unsuitable for chemotherapy were assigned to accelerated fractionation with concomitant boost (AF-CB, 69.6 Gy/39 fractions) over 5.5 weeks (group A) and 72 patients to cisplatin-based radiochemotherapy (70 Gy/35 fractions) over 7 weeks (group B). Groups were matched (cancer site, gender, age, performance score, T-/N-stage, histologic grade) and compared for loco-regional control (LRC), metastases-free survival (MFS), overall survival (OS) and toxicities. RESULTS: LRC, MFS, OS and radiation-related toxicities were not significantly different between groups A and B. Improved outcomes were associated with favorable cancer site, better performance score and T3-stage. In group B, toxicity led to reduction/discontinuation of chemotherapy in 38.9% and interruptions of radiotherapy >7 days in 19.3% of patients. CONCLUSION: AF-CB appeared a reasonable alternative for patients who cannot safely receive radio-chemotherapy for unresectable SCCHN. Copyright
BACKGROUND/AIM: Patients with unresectable head-and-neck cancer (SCCHN) unable to tolerate radiochemotherapy may receive unconventionally fractionated radiotherapy. This retrospective study compared both treatments. PATIENTS AND METHODS: Eight patients unsuitable for chemotherapy were assigned to accelerated fractionation with concomitant boost (AF-CB, 69.6 Gy/39 fractions) over 5.5 weeks (group A) and 72 patients to cisplatin-based radiochemotherapy (70 Gy/35 fractions) over 7 weeks (group B). Groups were matched (cancer site, gender, age, performance score, T-/N-stage, histologic grade) and compared for loco-regional control (LRC), metastases-free survival (MFS), overall survival (OS) and toxicities. RESULTS: LRC, MFS, OS and radiation-related toxicities were not significantly different between groups A and B. Improved outcomes were associated with favorable cancer site, better performance score and T3-stage. In group B, toxicity led to reduction/discontinuation of chemotherapy in 38.9% and interruptions of radiotherapy >7 days in 19.3% of patients. CONCLUSION:AF-CB appeared a reasonable alternative for patients who cannot safely receive radio-chemotherapy for unresectable SCCHN. Copyright
Authors: Dirk Rades; Britta Warwas; Karsten Gerull; Ralph Pries; Anke Leichtle; Karl L Bruchhage; Samer G Hakim; Steven E Schild; Florian Cremers Journal: In Vivo Date: 2022 Jul-Aug Impact factor: 2.406