Single-cycle induction chemotherapy before chemoradiotherapy or surgery in functionally inoperable head and neck squamous cell carcinoma: 10-year results.


Journal

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
ISSN: 1434-4726
Titre abrégé: Eur Arch Otorhinolaryngol
Pays: Germany
ID NLM: 9002937

Informations de publication

Date de publication:
Jan 2020
Historique:
received: 14 05 2019
accepted: 20 09 2019
pubmed: 5 10 2019
medline: 18 11 2020
entrez: 5 10 2019
Statut: ppublish

Résumé

The response to induction chemotherapy (IC) predicts local control after conservative treatment of laryngeal, meso- and hypopharyngeal head and neck squamous cell carcinoma (HNSCC) and can thus help to avoid surgery. Single-cycle induction chemotherapy may help to maintain a low local recurrence rate while keeping the overall toxicity manageable. However, long-term data on single-cycle IC response by tumor location is lacking. N = 102 patients with functionally inoperable primary HNSCC of the larynx (n = 43), hypopharynx (n = 42) or mesopharynx/tongue (n = 17) received one cycle of docetaxel (75 mg/m The overall response rate was 72.5%. All 74 responders and 10 non-responders received primary CRT, and 18 patients received primary surgery after single-cycle IC. Overall 10-year local recurrence-free survival (LRFS) was 73.7%. Three-year LRFS was 88.2% (mesopharynx/tongue), 88.2% (larynx), and 73.3% (hypopharynx); p = 0.17. 3-year distant metastasis-free survival (DMFS) was 94.1% (mesopharynx/tongue), 88.0% (larynx) and 76.4% (hypopharynx); p > 0.05. This influenced the 3-year cancer-specific survival (CSS) for larynx (91.2%) vs. hypopharynx tumors (60.8%); p = 0.003, but CSS was not different to tumors in the mesopharynx/tongue (81.4%); p > 0.05. A single-cycle induction chemotherapy for HNSCC enables surgery plus adjuvant therapy as well as chemoradiotherapy. The long-term local and distant disease control was good but varied between tumors in the larynx and mesopharynx/tongue vs. hypopharynx.

Identifiants

pubmed: 31583430
doi: 10.1007/s00405-019-05665-5
pii: 10.1007/s00405-019-05665-5
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

245-254

Références

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Auteurs

Marius Breheret (M)

Department of Radiation Oncology, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstrasse 27, 91054, Erlangen, Germany.

Dorota Lubgan (D)

Department of Radiation Oncology, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstrasse 27, 91054, Erlangen, Germany.

Marlen Haderlein (M)

Department of Radiation Oncology, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstrasse 27, 91054, Erlangen, Germany.

Markus Hecht (M)

Department of Radiation Oncology, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstrasse 27, 91054, Erlangen, Germany.

Maximilian Traxdorf (M)

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054, Erlangen, Germany.

Daniela Schmidt (D)

Department of Nuclear Medicine, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany.

Sarina Müller (S)

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054, Erlangen, Germany.

Christian Kitzsteiner (C)

Department of Radiation Oncology, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstrasse 27, 91054, Erlangen, Germany.

Torsten Kuwert (T)

Department of Nuclear Medicine, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Germany.

Heinrich Iro (H)

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Waldstrasse 1, 91054, Erlangen, Germany.

Rainer Fietkau (R)

Department of Radiation Oncology, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstrasse 27, 91054, Erlangen, Germany.

Sabine Semrau (S)

Department of Radiation Oncology, University Hospital, Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Universitätsstrasse 27, 91054, Erlangen, Germany. sabine.semrau@uk-erlangen.de.

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