Is Locally Advanced Head-Neck Cancer One More Candidate for Accelerated Hypofractionation?
Adult
Aged
Aged, 80 and over
Chemoradiotherapy
Combined Modality Therapy
Dose Fractionation, Radiation
Female
Head and Neck Neoplasms
/ mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Metastasis
Neoplasm Staging
Prognosis
Radiation Dose Hypofractionation
Radiotherapy Dosage
Radiotherapy, Intensity-Modulated
/ adverse effects
Treatment Outcome
Young Adult
Locally advanced head-neck cancer
acceleration
chemo-radiation
hypofractionation
radiotherapy
Journal
Anticancer research
ISSN: 1791-7530
Titre abrégé: Anticancer Res
Pays: Greece
ID NLM: 8102988
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
21
11
2020
accepted:
02
12
2020
entrez:
9
1
2021
pubmed:
10
1
2021
medline:
26
1
2021
Statut:
ppublish
Résumé
Hypofractionated accelerated radiotherapy (HypoAR) is widely applied for the treatment of early laryngeal cancer. Its role in locally advanced head-neck cancer (LA-HNC) is unexplored. We present results of a prospective trial on 124 patients with LA-HNC, treated with radio-chemotherapy with three different HypoAR fractionations (3.5 Gy/day × 14-15 fractions, 2.7 Gy/day × 20-21 fractions, and 2.5 Gy/day × 21-22 fractions). Protraction of the overall treatment time due to oropharyngeal mucositis was enforced in 18/57 laryngeal, 6/19 nasopharyngeal, and 15/48 cancer patients with other tumors. Regarding late toxicities, laryngeal edema grade 3 was noted in 5/57 patients with laryngeal cancer, while severe dysphagia was noted in 4/124 and tracheoesophageal fistula formation in 1/124 patients. The complete response rates obtained were 73%, 84%, and 67% in patients with laryngeal, nasopharyngeal, and other tumors, respectively. The 3-year locoregional progression-free survival was 58%, 73%, and 55%, respectively. HypoAR chemoradiotherapy is feasible, with acceptable early and late radiotherapy toxicities, response rates and LPFS.
Sections du résumé
BACKGROUND/AIM
OBJECTIVE
Hypofractionated accelerated radiotherapy (HypoAR) is widely applied for the treatment of early laryngeal cancer. Its role in locally advanced head-neck cancer (LA-HNC) is unexplored.
PATIENTS AND METHODS
METHODS
We present results of a prospective trial on 124 patients with LA-HNC, treated with radio-chemotherapy with three different HypoAR fractionations (3.5 Gy/day × 14-15 fractions, 2.7 Gy/day × 20-21 fractions, and 2.5 Gy/day × 21-22 fractions).
RESULTS
RESULTS
Protraction of the overall treatment time due to oropharyngeal mucositis was enforced in 18/57 laryngeal, 6/19 nasopharyngeal, and 15/48 cancer patients with other tumors. Regarding late toxicities, laryngeal edema grade 3 was noted in 5/57 patients with laryngeal cancer, while severe dysphagia was noted in 4/124 and tracheoesophageal fistula formation in 1/124 patients. The complete response rates obtained were 73%, 84%, and 67% in patients with laryngeal, nasopharyngeal, and other tumors, respectively. The 3-year locoregional progression-free survival was 58%, 73%, and 55%, respectively.
CONCLUSION
CONCLUSIONS
HypoAR chemoradiotherapy is feasible, with acceptable early and late radiotherapy toxicities, response rates and LPFS.
Identifiants
pubmed: 33419845
pii: 41/1/467
doi: 10.21873/anticanres.14797
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
467-475Informations de copyright
Copyright© 2021, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.