Survival of patients with head and neck cancer

Sadat, F.; Wienke, Andreas; Dunst, Juergen; Kuhnt, Thomas

doi:10.1007/s00066-011-0009-8

Cited by 21 publications

(11 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The majority of publications refer to the first mentioned option. [7][8][9][10][11][12][13][14][15] Less frequent were attempts of RT as an alone utility. [16][17][18][19][20] Some individual publications describe a combination of RT and surgery.…”

Section: Discussionmentioning

confidence: 99%

Split-course accelerated hyperfractionated irradiation (CHA-CHA) as a sole treatment for advanced head and neck cancer patients—final results of a randomized clinical trial

Miszczyk

Maciejewski²,

Tukiendorf³

et al. 2014

BJR

View full text Add to dashboard Cite

Objective: Evaluation of the efficacy and toxicity of splitcourse accelerated hyperfractionated irradiation (CHA-CHA) as a sole treatment for advanced head and neck (H&N) cancer patients. Methods: We enrolled 101 patients (39 in CHA-CHA and 37 in conventional (Conv.) arm completed the treatment). The CHA-CHA arm patients were irradiated twice a day, 7 days a week, using a fraction dose (fd) of 1.6 Gy up to 64 Gy with an 8-day gap in midterm. Patients in the control (Conv.) arm group were irradiated with a fd of 2 Gy, five times a week to a total dose of 72-74 Gy in the overall treatment time of 50-53 days. Quality of life (QOL) and acute mucosal reaction were evaluated during radiotherapy (RT). After RT, we followed the effect of treatment, QOL, performance status and adverse effects of radiation. For statistical analysis mainly a hierarchical multilevel modelling was used.Results: QOL was most deteriorated in the CHA-CHA arm; the CHA-CHA scheme also caused a relatively stronger acute injury. There were no significant differences in late adverse effects. In the CHA-CHA arm in 35% and in Conv. arm in 30% of patients, disease was controlled during follow-up. Tumour regression 1 year after the treatment was significantly better in the CHA-CHA arm. However, the overall survival rate analysis did not show significant difference between both arms. Conclusion: Despite differences in treatment results, we cannot conclude that split-course accelerated hyperfractionated irradiation is superior to conventionally fractionated RT as a sole treatment for advanced H&N cancer patients. Advances in knowledge: Obtained results in the context of published data support the statement that altered fractionations alone do not give an advantage for advanced H&N cancer patients.There are, and have been, many attempts to create a clear and effective treatment modality for advanced inoperable head and neck (H&N) cancers. The most common are different combinations of chemoradiotherapy, or different schedules of altered and usually intensive radiation treatment. It is clear that intense dose delivery combined with a high total dose (TD) and short treatment time gives a higher probability of tumour destruction; unfortunately, it is also connected with a higher, usually unacceptable, risk of normal tissue damage. One of the causes of radiation toxicity in such cases is the inability of sufficient repair of healthy tissue damage.The reason for this is the intensity of dose delivery and the lack of time for repopulation of normal cells and proper repair. On the other hand, the accelerated repopulation of squamous cancer cells starts 4 weeks after radiotherapy (RT); therefore, radiation treatment should be completed in that time. Considering the aforementioned facts, we tried to construct a very intense and short RT schedule allowing for normal tissue (mainly mucosa) repair. We went back to the old concept of split-course RT and combined it with accelerated, continuous, intense hyperfractionation.Finally, we proposed twice-a-day irradiation, usi...

show abstract

Section: Discussionmentioning

confidence: 99%

Split-course accelerated hyperfractionated irradiation (CHA-CHA) as a sole treatment for advanced head and neck cancer patients—final results of a randomized clinical trial

Miszczyk

Maciejewski²,

Tukiendorf³

et al. 2014

BJR

View full text Add to dashboard Cite

show abstract

“…First, our list of confounding variables was extensive but it was not exhaustive. For example, anemia at diagnosis and performance status has been reported as potential predictors of survival in people with head and neck cancer 6,9,16,35,43,44 but were not collected in our study. Types and details of comorbid conditions were not recorded.…”

Section: Strength and Limitationsmentioning

confidence: 99%

Association between comorbidity and survival in head and neck cancer: Results from Head and Neck 5000

et al. 2018

View full text Add to dashboard Cite

Background People with head and neck cancer (HNC) have higher comorbidity levels but it remains unclear if pre-treatment comorbidity is an independent prognosticator in HNC. Methods Survival analyses were performed using data from participants in a UK multicentre cohort study with cancers of the oral cavity (n = 668), oropharynx (n = 1,074) and larynx (n = 530). Survival analyses were incrementally adjusted for age, gender, marital status, income, education, stage, alcohol and smoking. Results After adjusting for demographic, clinical and behavioural confounders, higher baseline comorbidity was associated with reduced overall survival (mild comorbidity HR 1.4, 95% CI 1.1, 1.7; moderate comorbidity HR 1.7, 95% CI 1.3, 2.2; severe comorbidity HR 2.8, 95% CI 1.9, 4.; p-trend<.001). Conclusions Our findings suggest that comorbidity is an independent prognosticator for overall survival in HNC. Comorbid illnesses should be considered in the assessment and treatment planning of people with HNC.

show abstract

“…Locally advanced HNSCC has historically been difcult to treat because of its large tumor size, the local invasion of critical structures, high hypoxic cell fraction centrally, and patient comorbidities that preclude a curative approach. 2 Te traditional palliative dosing schedule for advanced HNSCC is 30 Gy/10 fractions over a 2-week period. 3 Tere is growing evidence, however, that a hypofractionated schedule may be more efcacious for several reasons, including increased patient compliance, better evaluation of treatment efcacy, lower rates of acute toxicity, and delayed late fbrosis.…”

mentioning

confidence: 99%

Cyclical hypofractionated radiotherapy technique for palliative treatment of locally advanced head and neck cancer: institutional experience and review of palliative regimens

Finnegan

Bhatt

Shaughnessy

et al. 2016

J Community Support Oncol

View full text Add to dashboard Cite

show abstract

Survival of patients with head and neck cancer

Abstract: Our retrospective analysis shows that performance status with dependency on comorbidities was an independent risk factor for OS.

Cited by 21 publications

References 31 publications

Split-course accelerated hyperfractionated irradiation (CHA-CHA) as a sole treatment for advanced head and neck cancer patients—final results of a randomized clinical trial

Split-course accelerated hyperfractionated irradiation (CHA-CHA) as a sole treatment for advanced head and neck cancer patients—final results of a randomized clinical trial

Association between comorbidity and survival in head and neck cancer: Results from Head and Neck 5000

Cyclical hypofractionated radiotherapy technique for palliative treatment of locally advanced head and neck cancer: institutional experience and review of palliative regimens

Contact Info

Product

Resources

About