Comparison of radiochemotherapy alone to surgery plus radio(chemo)therapy for non-metastatic stage III/IV squamous cell carcinoma of the head and neck

Rades, Dirk; Meyners, Thekla; Kazic, Nadja; Bajrovic, Amira; Rudat, Volker; Schild, Steven E.

doi:10.1007/s00066-011-2262-2

Cited by 17 publications

(8 citation statements)

References 19 publications

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“…The 3-year disease-free survival rate was 54% for patients treated with surgery plus RT and 43% for those treated with CCRT (p = 0.425), and no subset analysis of patients with OPC was performed. Rades et al [17] performed a matched-pair analysis in which 148 patients with advanced head and neck squamous cell carcinoma treated with CCRT were matched with 148 patients treated with surgery plus RT, including 134 patients with OPC. Although they reported that the outcomes after treatment with CCRT appeared similar to those after surgery plus RT, no subset analysis of patients with OPC was performed.…”

Section: Discussionmentioning

confidence: 99%

Matched-Pair Analysis in Patients with Advanced Oropharyngeal Cancer: Surgery versus Concurrent Chemoradiotherapy

Kano

Homma²,

Hayashi³

et al. 2013

Oncology

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Objective: The current study aimed to compare the therapeutic outcomes of surgery with those of chemoradiation for patients with advanced oropharyngeal cancer (OPC). Methods: The data for 523 patients with previously untreated OPC were obtained from 12 institutions belonging to the Head and Neck Cancer Study Group in the Japan Clinical Oncology Group from April 2005 to March 2007. In this study, we matched a group of patients who underwent surgery with a second group treated with chemoradiation according to age, gender, subsite, and T and N classification, and analyzed the overall survival, progression-free survival, local control and swallowing function. Results: The final matched-pair analysis included 186 patients. The 5-year overall survival, progression-free survival and local control rates were 69.8 and 71.4% (p = 0.762), 51.0 and 54.4% (p = 0.531), and 75.2 and 80.3% (p = 0.399), respectively, in patients treated with surgery and those treated with chemoradiation. Swallowing function in patients treated with chemoradiation was significantly better than that in patients treated with surgery (p = 0.015). Conclusion: Although this study was not randomized, this matched-pair analysis of patients treated with surgery or chemoradiation showed that chemoradiation is as effective as surgery in the treatment of OPC.

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Section: Discussionmentioning

confidence: 99%

Matched-Pair Analysis in Patients with Advanced Oropharyngeal Cancer: Surgery versus Concurrent Chemoradiotherapy

Kano

Homma²,

Hayashi³

et al. 2013

Oncology

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“…The choice of treatment strategy for laryngeal cancer varies in different oncology centres and depends mainly on the acquired clinical experience as well as on the adopted guidelines regarding therapeutic management in a given centre [1,2,3,4,5,6,7,8,9,10]. The majority of indications for adjuvant radiotherapy are based on the data obtained from microscopic analysis of the surgical specimen [11].…”

Section: Introductionmentioning

confidence: 99%

“…The decision regarding potential adjuvant therapy is also influenced, to some extent, by the type of surgical procedure (partial, total) [12]. Correlations between various clinical and pathological parameters and the risk of recurrence have been described in numerous reports [9,13,14,15,16].…”

Section: Introductionmentioning

confidence: 99%

Histopathological factors influencing results of combined treatment in patients with laryngeal cancer

Mucha-Małecka¹,

Składowski²,

Lange³

2015

pjp

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The aim of the study was to assess the prognostic value of postoperative histopathological factors as well as the clinical usefulness of the modified risk score for recurrence. In a group of 197 patients with laryngeal cancer who underwent surgery followed by radiation therapy, partial resection was performed in 21.5% of patients and total resection in 78.5%. The majority of patients had T3 or T4 (74%) and N0 (63%) cancer. Macroscopically positive margins were reported in 10% of patients after partial resection and in 7% of patients after total resection, whereas microscopically positive margins were observed in 31% and 20% of cases, respectively. Extracapsular extension was observed in 22% of patients. In order to estimate local and nodal recurrence risk rates, criteria developed by Peters were used. Five-year local control (LC) was achieved in 88% of patients, disease-free survival (DFS) in 68% of patients and overall survival (OS) in 73% of patients. In the case of macroscopically positive margins, the 5-year DFS was 33% lower compared to radical surgery and 25% lower in the case of microscopically positive margins. The 5-year DFS was reduced by 29% due to extracapsular extension. Cox model analysis indicated that the degree of recurrence risk was the most potent independent prognostic factor for postoperative radiation therapy in laryngeal cancer. Negative histopathological factors influencing results of combined treatment of laryngeal cancer include macro-and microscopically positive margins, neck lymph node involvement and extracapsular extension.

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“…Despite advances in the non-surgical management of head and neck squamous cell carcinoma (HNSCC), locoregional failure remains a major cause of morbidity and mortality in this patient population [14,15]. However, early and late side effects limit the overall treatment intensity in unselected cases [11].…”

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confidence: 99%

Methods for estimating the site of origin of locoregional recurrence in head and neck squamous cell carcinoma

et al. 2012

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Comparison of radiochemotherapy alone to surgery plus radio(chemo)therapy for non-metastatic stage III/IV squamous cell carcinoma of the head and neck

Abstract: Outcomes of radiochemotherapy alone appeared similar to those of surgery plus radio(chemo)therapy. Randomized trials comparing both treatments for different tumor sites are warranted.

Cited by 17 publications

References 19 publications

Matched-Pair Analysis in Patients with Advanced Oropharyngeal Cancer: Surgery versus Concurrent Chemoradiotherapy

Matched-Pair Analysis in Patients with Advanced Oropharyngeal Cancer: Surgery versus Concurrent Chemoradiotherapy

Histopathological factors influencing results of combined treatment in patients with laryngeal cancer

Methods for estimating the site of origin of locoregional recurrence in head and neck squamous cell carcinoma

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