Randomized trial comparing two methods of re-irradiation after salvage surgery in head and neck squamous cell carcinoma: Once daily split-course radiotherapy with concomitant chemotherapy or twice daily radiotherapy with cetuximab.
Radiother Oncol
; 128(3): 467-471, 2018 09.
Article
em En
| MEDLINE
| ID: mdl-29784451
ABSTRACT
BACKGROUND:
A previous randomized trial in recurrent Head and Neck squamous-cell carcinoma (HNSCC) has shown re-irradiation combined with chemotherapy after salvage surgery significantly improved disease-free survival (DFS). The objective of this randomized trial was to compare two methods of re-irradiation in terms of toxicity and survival. PATIENTS ANDMETHODS:
Patients with recurrence/second primary in previously irradiated area were randomly allocated to receive either 60â¯Gy over 11â¯weeks with concomitant 5FU - hydroxyurea (VP-arm), or 60â¯Gy (1.2â¯Gy twice daily) over 5â¯weeks with cetuximab (HFR-arm). Primary endpoint was treatment interruption >15â¯days (acute toxicity).RESULTS:
Twenty-six patients were included in VP-arm and 27 in HFR-arm. One patient in VP-arm experienced >15â¯days interruption due to toxicity, and none in HFR-arm. In both arms, all patients received at least 60â¯Gy. In VP-arm, 8/26 patients had chemotherapy delay and/or dose reduction. In HFR-arm, 4/27 patients had <6 cycles cetuximab. There was no significant difference in overall survival (Median OS 37.4â¯months vs 21.9â¯months, pâ¯=â¯0.12). Toxicities and DFS were not different between 2 arms.CONCLUSIONS:
Twice daily schedule of re-irradiation of 60â¯Gy/5 weeks with cetuximab was tolerable and no significant difference in treatment delays occurred between two arms.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Carcinoma de Células Escamosas
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Quimiorradioterapia
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Reirradiação
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Neoplasias de Cabeça e Pescoço
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article