Hyperfractionated Accelerated Radiotherapy versus Conventional Fractionation Both Combined with Chemotherapy in Patients with Locally Advanced Head and Neck Carcinomas: A Retrospective Analysis of a Monoinstitutional Series

Hyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from randomized trials are available for a comparison with conventionally fractionated radiotherapy (CFRT) and CC. This monoinstitutional retrospective st...

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Published inOncology Vol. 76; no. 6; pp. 405 - 412
Main Authors WELZ, Hanna, POTTGEN, Christoph, STUSCHKE, Martin, JAWAD, Jehad Abu, WIERLEMANN, Arne, WITTIG, Andrea, STÜBEN, Georg, BUDACH, Volker, LEHNERDT, Goetz, JAHNK, Klaus, SACK, Horst
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Published Basel Karger 01.01.2009
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Abstract Hyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from randomized trials are available for a comparison with conventionally fractionated radiotherapy (CFRT) and CC. This monoinstitutional retrospective study compares the results of both treatment schedules: 315 patients with locally advanced carcinoma (UICC stage III and IV) of the oral cavity and the orohypopharynx were treated from January 1990 to March 2006 with a radiochemotherapy combination based on mitomycin C and fluorouracil (HART-CC: 203 patients, CFRT-CC: 112 patients, total dose: 70-72 Gy) with curative intent. Two- and 4-year survival was 60 and 42 (HART-CC) and 59 and 42% (CFRT-CC; p = 0.82, log-rank test), respectively. Using multivariate Cox regression, pretreatment hemoglobin level, N stage, tumor site but not the year of treatment, gender and T stage were significant prognosticators for survival. For locoregional control, only N stage was significant. The prognostic value of these pretreatment factors did not variate with the fractionation schedule used. In combination with CC, there was no trend towards an improved efficacy of HART in comparison with CFRT.
AbstractList OBJECTIVEHyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from randomized trials are available for a comparison with conventionally fractionated radiotherapy (CFRT) and CC.METHODSThis monoinstitutional retrospective study compares the results of both treatment schedules: 315 patients with locally advanced carcinoma (UICC stage III and IV) of the oral cavity and the orohypopharynx were treated from January 1990 to March 2006 with a radiochemotherapy combination based on mitomycin C and fluorouracil (HART-CC: 203 patients, CFRT-CC: 112 patients, total dose: 70-72 Gy) with curative intent.RESULTSTwo- and 4-year survival was 60 and 42 (HART-CC) and 59 and 42% (CFRT-CC; p = 0.82, log-rank test), respectively. Using multivariate Cox regression, pretreatment hemoglobin level, N stage, tumor site but not the year of treatment, gender and T stage were significant prognosticators for survival. For locoregional control, only N stage was significant. The prognostic value of these pretreatment factors did not variate with the fractionation schedule used.CONCLUSIONSIn combination with CC, there was no trend towards an improved efficacy of HART in comparison with CFRT.
Hyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from randomized trials are available for a comparison with conventionally fractionated radiotherapy (CFRT) and CC. This monoinstitutional retrospective study compares the results of both treatment schedules: 315 patients with locally advanced carcinoma (UICC stage III and IV) of the oral cavity and the orohypopharynx were treated from January 1990 to March 2006 with a radiochemotherapy combination based on mitomycin C and fluorouracil (HART-CC: 203 patients, CFRT-CC: 112 patients, total dose: 70-72 Gy) with curative intent. Two- and 4-year survival was 60 and 42 (HART-CC) and 59 and 42% (CFRT-CC; p = 0.82, log-rank test), respectively. Using multivariate Cox regression, pretreatment hemoglobin level, N stage, tumor site but not the year of treatment, gender and T stage were significant prognosticators for survival. For locoregional control, only N stage was significant. The prognostic value of these pretreatment factors did not variate with the fractionation schedule used. In combination with CC, there was no trend towards an improved efficacy of HART in comparison with CFRT.
Author STUSCHKE, Martin
JAWAD, Jehad Abu
STÜBEN, Georg
POTTGEN, Christoph
SACK, Horst
WELZ, Hanna
JAHNK, Klaus
LEHNERDT, Goetz
WITTIG, Andrea
WIERLEMANN, Arne
BUDACH, Volker
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Issue 6
Keywords Antineoplastic agent
5-Fluorouracil
Cancerology
ENT disease
Mitomycin C
Head and neck carcinoma
Accelerated radiotherapy
Fluorouracil
Human
Drug combination
Fractionation
Mitomycin
Enzyme
Fluoropyrimidine derivatives
Transferases
Enzyme inhibitor
Malignant tumor
Thymidylate synthase
Radiotherapy
Retrospective
Concomitant chemotherapy
Hyperfractionation
Alkylating agent
Chemotherapy
Treatment
Antimetabolic
Methyltransferases
Pyrimidine derivatives
Head and neck cancer
Combined treatment
Locally advanced stage
Comparative study
Cancer
Language English
License CC BY 4.0
Copyright 2009 S. Karger AG, Basel.
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Snippet Hyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from...
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SubjectTerms Aged
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Biological and medical sciences
Carcinoma - drug therapy
Carcinoma - radiotherapy
Combined Modality Therapy - methods
Dose Fractionation
Female
Fluorouracil - administration & dosage
Head and Neck Neoplasms - drug therapy
Head and Neck Neoplasms - radiotherapy
Humans
Male
Medical sciences
Middle Aged
Mitomycin - administration & dosage
Otorhinolaryngology (head neck, general aspects and miscellaneous)
Otorhinolaryngology. Stomatology
Regression Analysis
Retrospective Studies
Treatment Outcome
Tumors
Title Hyperfractionated Accelerated Radiotherapy versus Conventional Fractionation Both Combined with Chemotherapy in Patients with Locally Advanced Head and Neck Carcinomas: A Retrospective Analysis of a Monoinstitutional Series
URI https://www.ncbi.nlm.nih.gov/pubmed/19407473
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Volume 76
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