E. Binnaz Sarper, Hatice Halis, M. Görkem Aksu, Eda Yirmibeşoğlu Erkal

Lokal İleri Evre Baş Boyun Kanseri Tanısı ile Organ Koruyucu Tedavi Protokolü Olarak Kemoradyoterapi Uygulanan Hastalarda Tedavi Yanıtının ve Sağkalımın Değerlendirilmesi

Amaç Bu çalışma, kemoradyoterapi ile tedavi edilen, lokal ileri evre baş boyun kanserli hastaların genel sağkalım ve hastalıksız sağkalım oranlarını araştırmak amacıyla yapıldı. Gereç ve Yöntemler Çalışmamıza kemoradyoterapi alan 35 hasta ve radyoterapi alan 19 hasta olmak üzere toplam 54 hasta dahil edildi. Tümörler larinks (%74), hipofarinks (%17) ve oral kavite (%9) yerleşimli idi. TNM evresine göre, 54 vakadan biri T1, 10’u T2, 25’i T3 ve 18’i T4 evresindeydi. Ayrıca 29’u N0, 11’i N1, 13’ü N2 ve biri N3’tü. Primer tümöre, ortalama 70 Gy (64-74); lenf nodlarına ise risk gruplarına göre 50 ila 70 Gy arasında konformal veya yoğunluk ayarlı radyoterapi uygulandı. Tedavi yanıtı, sağkalım ve hastalıksız sağkalım oranları belirlendi. Bulgular Takip süresi 3 ay ile 53 ay arasında değişmekteydi (ortanca = 18 ay). Tedavinin tamamlanmasından 2 ay sonra, 50 hastanın 36’sında (% 72) klinik ve radyolojik olarak tam bir yanıt gözlendi. On iki hastada (% 24) kısmi bir yanıt, 2 hastada (% 4) progresyon tespit edildi. Genel sağkalım ve hastalıksız sağkalım oranları 3 yıl boyunca sırasıyla % 51 ve % 58 olarak bulundu. En sık görülen yan etki, hastaların% 40’ında saptanan mukozit idi. Sistemik tedavinin en sık görülen yan etkileri bulantı, kusma ve lökopeni idi (% 34). Ağız kuruluğu en sık görülen geç yan etkiydi. Sonuç: Radikal radyoterapi veya kemoradyoterapi, lokal ileri evre baş boyun tümörlerinde kabul edilebilir toksisite oranları ile alternatif bir tedavi yöntemidir. Sonuç Radikal radyoterapi veya kemoradyoterapi, lokal ileri evre baş boyun tümörlerinde kabul edilebilir toksisite oranları ile alternatif bir tedavi yöntemidir.

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

bstractObjective 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 treatedwith chemoradiotherapy (CRT).Materialsand MethodsA total of 54 patients were included in our study. Among 54, 35 were treated with chemoradiotherapy and 19 were treated with radiotherapy only. The tumors were locatedin larynx (74%), hypopharynx (17%) and oral cavity (9%). According to TNM stage, among 54 case, one was T1, 10 were T2, 25 were T3 and 18 were T4 stage. Furthermore,29 were N0, 11 were N1, 13 were N2 and one was N3 stage. The primary tumor was irradiated with conformal or intensity-modulated radiotherapy at an average dose of 70Gy (64–74), and lymph nodes at a dose of 50 to 70 Gy depending on risk groups. Treatment response, OS and DFS rates were identified in 50 case.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 patientsafter 2 months from completion of treatment. A partial response was detected in 12 patients (24%) and progression in 2 patients (4%). The rates of OS and DFS over theperiod of 3 years were found to be 51% and 58%, respectively. The most common side effect was mucositis detected in 40% of the patients. The most common side effectsof systemic treatment were nausea, vomiting and leukopenia (34%). Dry mouth was found to be the most frequent late side effect.Conclusion Radical radiotherapy or chemoradiotherapy is an alternative treatment method of locally advanced head and neck tumors, with acceptable toxicity rates.

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