Decrease in treatment intensity predicts worse outcome in patients with locally advanced head and neck squamous cell carcinoma undergoing radiochemotherapy
| العنوان: | Decrease in treatment intensity predicts worse outcome in patients with locally advanced head and neck squamous cell carcinoma undergoing radiochemotherapy |
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| المؤلفون: | Karin S. Kapp, Florian Posch, Florian Moik, Armin Gerger, Thomas Weiland, Herbert Stöger, Angelika Terbuch, S Vasicek, Florian Eisner, S. Mollnar, Prisca Pondorfer, Michael Halm, Joanna Szkandera, Richard Partl, S. Reinisch, Anne-Katrin Kasparek, Michael Stotz, Dietmar Thurnher, Martin Pichler |
| المصدر: | Clinical & Translational Oncology |
| بيانات النشر: | Springer Science and Business Media LLC, 2020. |
| سنة النشر: | 2020 |
| مصطلحات موضوعية: | Radiation-Sensitizing Agents, Cancer Research, medicine.medical_treatment, Dermatitis, HNSCC, Gastroenterology, Carboplatin, chemistry.chemical_compound, 0302 clinical medicine, Medicine, 030223 otorhinolaryngology, Radiotherapy Dosage, Chemoradiotherapy, Induction Chemotherapy, General Medicine, Middle Aged, Progression-Free Survival, Treatment Outcome, Oncology, Docetaxel, Head and Neck Neoplasms, 030220 oncology & carcinogenesis, Female, Stomatitis, Aphthous, Research Article, medicine.drug, medicine.medical_specialty, Xerostomia, 03 medical and health sciences, Internal medicine, Humans, ddc:610, Progression-free survival, Radiochemotherapy, Aged, Retrospective Studies, Chemotherapy, Toxicity, Squamous Cell Carcinoma of Head and Neck, business.industry, Induction chemotherapy, Leukopenia, medicine.disease, Head and neck squamous-cell carcinoma, Radiation therapy, chemistry, Radiotherapy, Intensity-Modulated, Cisplatin, Treatment modification, business |
| الوصف: | Purpose Radiochemotherapy (RCT) is an effective standard therapy for locally advanced head and neck squamous cell carcinoma (LA-HNSCC). Nonetheless, toxicity is common, with patients often requiring dose modifications. Methods To investigate associations of RCT toxicities according to CTCAE version 5.0 and subsequent therapy modifications with short- and long-term treatment outcomes, we studied all 193 patients with HNSCC who received RCT (70 Gy + platinum agent) at an academic center between 03/2010 and 04/2018. Results During RCT, 77 (41%, 95% CI 34–49) patients developed at least one ≥ grade 3 toxicity, including seven grade 4 and 3 fatal grade 5 toxicities. The most frequent any-grade toxicities were xerostomia (n = 187), stomatitis (n = 181), dermatitis (n = 174), and leucopenia (n = 98). Eleven patients (6%) had their radiotherapy schedule modified (mean radiotherapy dose reduction = 12 Gy), and 120 patients (64%) had chemotherapy modifications (permanent discontinuation: n = 67, pause: n = 34, dose reduction: n = 7, change to other chemotherapy: n = 10). Objective response rates to RCT were 55% and 88% in patients with and without radiotherapy modifications (p = 0.003), and 84% and 88% in patients with and without chemotherapy modifications (p = 0.468), respectively. Five-year progression-free survival estimates were 20% and 50% in patients with and without radiotherapy modifications (p = p = 0.88), respectively. Conclusions Reductions of radiotherapy dose were associated with impaired long-term outcomes, whereas reductions in chemotherapy intensity were not. This suggests that toxicities during RCT should be primarily managed by modifying chemotherapy rather than radiotherapy. |
| وصف الملف: | application/pdf |
| تدمد: | 1699-3055 1699-048X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::64e6cd5196c4a5c7cce80e105ae12e14Test https://doi.org/10.1007/s12094-020-02447-yTest |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....64e6cd5196c4a5c7cce80e105ae12e14 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 16993055 1699048X |
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