Very accelerated radiotherapy or concurrent chemoradiotherapy for N3 head and neck squamous cell carcinoma: Pooled analysis of two GORTEC randomized trials.
Oral Oncol
; 71: 61-66, 2017 08.
Article
in En
| MEDLINE
| ID: mdl-28688693
ABSTRACT
OBJECTIVE:
To analyze the outcome of N3 patients treated with very accelerated radiotherapy (VART) or different schedules of concurrent chemoradiotherapy (CRT) within two phase III trials. PATIENTS ANDMETHODS:
Data of 179 patients with N3 HNSCC from two GORTEC randomized trials (96-01 and 99-02) were pooled. Patients received either VART 64.8Gy/3.5weeks or one of the 3 following CRT regimens Conventional CRT 70Gy/7weeks+3 cycles carboplatin-5FU; Moderately accelerated CRT 70Gy/6weeks+2 cycles carboplatin-5FU; Strongly intensified CRT 64Gy/5weeks+cisplatin (days 2, 16, 30) and 5 FU (days 1-5, 29-33) followed by 2 cycles adjuvant cisplatin-5FU.RESULTS:
Median follow-up was 13.3 and 5.2years for GORTEC 96-01 and GORTEC 99-02, respectively. Five-year overall survival (OS) was 13.8%. No significant difference was observed between CRT versus VART in terms of OS (hazard ratio [HR] 0.93, p=0.68), loco-regional progression (HR 0.70, p=0.13), or distant progression (HR 0.86, p=0.53). OS was worse for patients with T3-4 tumors versus early T stage (11.0% versus 25.7%, p=0.015). In multivariate analysis, the oropharyngeal subsite presented a higher risk of distant metastasis (as first event 46.5% vs 19.2%, p<0.001),). A significant interaction between treatment modalities and subsites has been observed concerning loco-regional and distant failures.CONCLUSION:
The outcome of N3 HNSCC was extremely poor despite treatment intensification and no difference between CRT and VART. Both distant metastases and loco-regional failures remain important treatment challenge.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Carcinoma, Squamous Cell
/
Antineoplastic Combined Chemotherapy Protocols
/
Chemoradiotherapy
/
Head and Neck Neoplasms
Type of study:
Clinical_trials
/
Prognostic_studies
Limits:
Female
/
Humans
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Male
/
Middle aged
Language:
En
Journal:
Oral Oncol
Journal subject:
NEOPLASIAS
Year:
2017
Document type:
Article