A multicentre randomized/controlled trial of a conventional versus modestly accelerated radiotherapy in the laryngeal cancer: influence of a 1 week shortening overall time.

BACKGROUND AND PURPOSE: To compare in a phase III study the loco-regional control, disease-free survival and overall survival induced by an accelerated regimen (AF) as compared with conventional regimen (CF) and to analyze the early and late post-radiation morbidity in both arms. MATERIALS AND METHODS: Patients with age < or = 75, WHO 0-1, suitable for a radical course of radiotherapy T1-T3, N0, M0, stage of glottic and supraglottic laryngeal cancer were randomized to either CF: 66Gy given in 33 fractions over 45 days or AF: 66Gy given in 33 fractions over 38 days (2 fractions every Thursday). A total of 395 patients were included from 05.1995 to 12.1998. RESULTS: Early toxicity: At the end of radiotherapy patients treated with AF complained for more severe reactions than patients treated with CF. In 8 weeks after treatment completion patients treated with AF complained only for more severe pain on swallowing (P=0.027). In 4 months after treatment completion all types of toxicity except for skin teleangiectasia (P=0.001) were similar in the two groups. Loco-regional control: comparison between CF and AF showed no difference in terms of loco-regional control (P=0.37). CONCLUSIONS: The improvement in AF in terms of loco-regional control is estimated to be 3-5% in comparison with conventional regimen and is not significant. The intensity of reactions after 4 months was similar in both arms, what suggests the possibility of further shortening of the overall time by few days or enhancing the total dose within the limits of acceptable morbidity.

[Concomitant radiochemotherapy for locally advanced oro- and hypopharyngeal cancer: tolerance and early results]. / Jednoczesna radiochemioterapia u chorych na raka gardla srodkowego i dolnego: tolerancja i wczesne wyniki leczenia.

Combination of radio- and chemotherapy is one of the methods which may improve results of treatment in patients with locally advanced head and neck cancer. Currently, the most promising sequence of radio- and chemotherapy is concomitant. In Head and Neck Cancer Department of Cancer Center in Warsaw since 1995 is continued study estimated tolerance and effectiveness of the concomitant radiochemotherapy for patients with locally advanced oro- and hypopharyngeal cancer. Chemotherapy consist of cisplatinum and 5-fluorouracil in continuous infusion during first week of irradiation followed by 24-hours infusion of 5-fluorouracil one weekly until radiotherapy is finished. Radiotherapy is used with conventional fractionation 2 Gy per fraction, 5 fractions weekly to total dose 66 Gy. Between October 1995 and September 1998 fifty seven patients with oropharyngeal cancer were entered to study. Tolerance of treatment was acceptable. Complete regression of the tumor was obtained in 41/57 patients (72%). Five other patients after radiotherapy were referred for successful radical neck dissection. Including this group, local control was obtained in 81%. At this moment, 60% of patients are alive without evidence of disease. In 12 patients with hypopharyngeal cancer tolerance of treatment and early results were poor, so the study was stopped in this group.

[Olfactory neuroblastoma: own experiences]. / Olfactory neuroblastoma--doswiadczenie wlasne.

The authors present material of 12 cases olfactory neuroblastoma observed in Head and Neck Department of Cancer Center in Warsaw from 1961 to 1998. The tumors were seen in 8 women and 4 men. According to Kadish staging there were one A, three B, and eight C stages tumors. Patient in stage A was treated with surgery and radiotherapy. One patient in stage B was treated with surgery and radiotherapy. Two patients in stage B were treated with radiotherapy alone. Six patients in stage C were treated also with surgery, radiotherapy and chemotherapy. Two patients in stage C were treated with surgery and radiotherapy. Complete regression was observed in 9 of 12 patients. One patient died from olfactory neuroblastoma, two other were died from other reasons.