Hatice HALİS, M. Görkem AKSU, Eda YİRMİBEŞOĞLU ERKAL, E. Binnaz SARPER

Assessment of Treatment Response and Survival in Patients Diagnosed with Locally Advanced Head and Neck Cancer and Treated with Chemoradiotherapy As Part of An Organ-Preservation Treatment Protocol

Objectives: This study was carried out to explore the overall survival (OS) and disease-free survival (DFS) rates of patients with locally advanced head and neck cancer who were treated with chemoradiotherapy (CRT). Methods: A total of 54 patients were included in our study, including 35 patients who were treated with chemoradiotherapy and 19 patients who were treated with radiotherapy only. The primary tumor was irradiated with conformal or intensity-modulated radiotherapy at an average dose of 70 Gy (64–74), and lymph nodes at a dose of 50 to 70 Gy depending on risk groups. Treatment response, survival and disease-free survival rates were identified. Results: The follow-up period ranged from 3 months to 53 months (median=18 months). A clinically and radiologically complete response was observed in 36 (72%) of 50 patients 2 months after the completion of treatment. A partial response was detected in 12 patients (24%) and progression in 2 patients (4%). The rates of overall survival (OS) and disease-free survival (DFS) over the period of 3 years were found to be 51% and 58%, respectively. Conclusion: Radical radiotherapy or chemoradiotherapy is an alternative method of treatment, with acceptable toxicity rates, in locally advanced head and neck tumors

Anahtar Kelimeler:

Head and neck cancer, locally advanced stage, radiotherapy

PDF

___

1. Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ. Cancer statistics, 2003. CA Cancer J Clin. 2003;53:5-26.
2. Jemal A, Siegel R, Xu J, Ward E. Cancer statistics, 2010. CA Cancer J Clin. 2010;60:277-300.
3. Lefebvre JL, Chevalier D, Luboinski B, Kirkpatrick A, Collette L, Sahmoud T. Larynx preservation in pyriform sinus cancer: preliminary results of a European Organization for Research and Treatment of Cancer phase III trial. EORTC Head and Neck Cancer Cooperative Group. J Natl Cancer Inst. 1996;88:890-9.
4. The Department of Veterans Affairs Laryngeal Cancer Study Group. Induction chemotherapy plus radiation compared with surgery plus radiation in patients with advanced laryngeal cancer. N Engl J Med. 1991;324:1685-90.
5. Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, editors. AJCC cancer staging manual. 7th ed. New York, NY: Springer, 2010.
6. Forastiere A, Koch W, Trotti A, Sidransky D. Head and neck cancer. N Engl J Med. 2001;345:1890-900.
7. Posner MR, Haddad RI, Wirth L, Norris CM, Goguen LA, Mahadevan A, et al. Induction chemotherapy in locally advanced squamous cell cancer of the head and neck: evolution of the sequential treatment approach. Semin Oncol. 2004;31:778-85.
8. Agrawal N, Ha PK. Management of early-stage laryngeal cancer. Otolaryngol Clin North Am. 2008;41:757-69.
9. Scher RL, Esclamado RM. Organ and function preservation: the role of surgery as the optimal primary modality or as salvage after chemoradiation failure. Semin Radiat Oncol. 2009;19:17-23.
10. Pignon JP, le Maître A, Bourhis J, MACH-NC Collaborative Group. Meta-analyses of chemotherapy in head and neck cancer (MACH-NC): an update. Int J Radiat Oncol Biol Phys. 2007;69:112-4.
11. Garden AS, Asper JA, Morrison WH, Schechter NR, Glisson BS, Kies MS, et al. Is concurrent chemoradiation the treatment of choice for all patients with Stage III or IV head and neck carcinoma? Cancer. 2004;100:1171-8.
12. Brizel DM, Albers ME, Fisher SR, Scher RL, Richtsmeier WJ, Hars V, et al. Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer. N Engl J Med. 1998;338:1798-804.
13. Cruz JJ, Ocaña A, Navarro M, Barco ED, Fonseca E. New options in the treatment of locally advanced head and neck cancer: role for induction chemotherapy. Cancer Treat Rev. 2008;34:268-74.
14. Forastiere AA, Goepfert H, Maor M, Pajak TF, Weber R, Morrison W, et al. Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer. N Engl J Med. 2003;349:2091-8.
15. Medina JA, Rueda A, de Pasos AS, Contreras J, Cobo M, Moreno P, et al. A phase II study of concomitant boast radiation plus concurrent weekly cisplatin for locally advanced unresectable head and neck carcinomas. Radiother Oncol. 2006;79:34-38.
16. Blanchard P, Baujat B, Holostenco V, Bourredjem A, Baey C, Bourhis J, et al. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): a comprehensive analysis by tumour site. Radiother Oncol. 2011;100:33-40.