Patterns of relapse in locally advanced head and neck cancer patients who achieved complete remission after combined modality therapy

Abstract

Relapse patterns in patients with locally advanced head and neck cancer who achieved complete remission were evaluated. After combined modality therapy with induction chemotherapy followed by surgery and/or radiotherapy, 71 of 103 patients were clinically free of disease. The 5-year recurrence rate was estimated at 51%, with a 39% local and 26% distant failure rate by 5 years. The factors significantly affecting the relapse patterns were: the site of the primary tumor (those with oral cavity lesions were more likely to fail locally, whereas hypopharynx patients had a higher risk of distant metastases); the type of definitive local treatment (those patients who received surgery and radiotherapy were at lower risk of pure local failure); TN Stage (patients with T4N3 or T3N3 tumor were at higher risk of both local and distant failure); and time to response and presence of oropharyngeal lesions (patients who had a longer period from diagnosis to final complete response [CR] and patients with oropharyngeal primaries were at higher risk for simultaneous local and distant failure). Type of chemotherapy, patient age, tumor differentiation, and response to induction chemotherapy did not significantly influence the patterns of relapse. A combined modality approach with induction chemotherapy, surgery, and/or radiotherapy does not seem to reduce the incidence of distant metastases significantly.

Intensive Concurrent Chemoradiotherapy for Head and Neck Cancer with 5-Fluorouracil- and Hydroxyurea-Based Regimens: Reversing a Pattern of Failure

“…Its use in both unresectable and resectable locoregionally advanced disease in an attempt at organ preservation could, therefore, be justified. More importantly, a reversal of the historical pattern of failure of head and neck cancer (local more often than distant) [52] was observed; a higher percentage of patients were found to fail distantly, usually in the lungs, than locally or regionally. An important study component was the prospective evaluation of quality of life (QOL) and functional outcomes [53].…”

18F-FDG PET as a Routine Posttreatment Surveillance Tool in Oral and Oropharyngeal Squamous Cell Carcinoma: A ProspectiveStudy

“…Besides this regular follow-up, all patients underwent serial 18 F-FDG PET investigations at set times (3,6,9, and 12 mo) after the completion of initial therapy. 18 F-FDG PET was planned on the same day as regular follow-up visits to the OPD.…”

“…Most recurrences occur within the first 2 y after treatment (2). The initial stage of the tumor has been shown to affect the recurrence rate, with stages III and IV having an increased recurrence risk as compared with stages I and II (3). Distant metastases are less frequently occurring, but nevertheless they are reported in approximately 5%210% of the HNSCC patients.…”

Serum decreases the size of Metafectene-and Genejammer-DNA complexes but does not affect significantly their transfection activity in SCCVII murine squamous cell carcinoma cells

“…Fifty two % of positively diagnosed patients have a mean survival time of only five years [3], a statistic that has not changed considerably over the past 20 years. Patients who survive a first cancer of the oral cavity have a 20-fold increased risk of developing a second primary oral cancer [4]. About 67% of patients dying of oral cancer have no evidence of symptomatic distant metastases; thus control of the localized or regional disease via effective therapies is of utmost importance.…”