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Head Neck ; 41(9): 3201-3210, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31116482


BACKGROUND: We hypothesized that patients with head and neck squamous cell carcinoma (HNSCC) with smoking cessation during curative chemoradiotherapy (CRT) had fewer complications and lower tumor progression risks. METHODS: Sixty-three patients with nonmetastatic HNSCC who were smokers at diagnosis (carbon monoxide [CO] breath concentrations ≥3 ppm) and underwent curative CRT were prospectively enrolled. Successful smoking cessation throughout CRT was confirmed by CO breath concentrations <3 ppm at CRT completion. RESULTS: Forty-one patients (65%) successfully discontinued smoking throughout CRT. With a median 33-month follow-up, patients with successful smoking cessation during CRT had significantly fewer, greater, and lower probabilities of grade ≥3 acute toxicities (P = .01), progression-free survival (P = .03), and permanent gastrostomy or tracheostomy (P = .04), respectively, than those continuing smoking throughout CRT. In multivariate analysis, successful smoking cessation during CRT significantly reduced tumor progression risks (hazard ratio: 0.4, P = .05). CONCLUSION: Smoking cessation during curative CRT reduced treatment-related toxicities and tumor progression risks in patients with HNSCC.

Head Neck ; 37(12): E186-90, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25821193


BACKGROUND: The main concerns with radiation therapy for head and neck cancer in human immunodeficiency virus (HIV)-infected patients include limited tumor response and profound mucosal or skin toxicities under severe immunocompromised status. METHODS: In this study, we describe the clinicopathological features, chronological changes in HIV viral loads and CD4 counts, and treatment outcomes of definitive radiotherapy for locally advanced head and neck cancer in an HIV-infected patient. RESULTS: Despite low CD4 counts (80 cells/µL), a combination of highly active antiretroviral therapy (HAART) and definitive concurrent chemoradiotherapy (70 Gy of simultaneously integrated boost intensity-modulated radiotherapy (IMRT), fluorouracil, and leucovorin) was well-tolerated. Grade 3 mucositis and dermatitis were resolved 2 weeks after treatment completion. The patient was alive and remained disease-free 31 months after treatment. CONCLUSION: For patients with HIV diagnosed with locally advanced head and neck cancer, good tolerance and outcome can be achieved with definitive radiotherapy while on HAART.

Terapia Antirretroviral de Alta Atividade/métodos , Carcinoma de Células Escamosas/terapia , Quimiorradioterapia Adjuvante , Infecções por HIV/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/terapia , Hospedeiro Imunocomprometido , Radioterapia de Intensidade Modulada , Contagem de Linfócito CD4 , Carcinoma de Células Escamosas/complicações , Quimiorradioterapia Adjuvante/métodos , Infecções por HIV/complicações , Infecções por HIV/diagnóstico , Neoplasias de Cabeça e Pescoço/complicações , Neoplasias de Cabeça e Pescoço/diagnóstico , Humanos , Neoplasias Laríngeas/terapia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Dosagem Radioterapêutica , Radioterapia de Intensidade Modulada/métodos , Indução de Remissão , Resultado do Tratamento , Carga Viral/efeitos dos fármacos