The effect of treatment time and treatment interruption on tumour control following radical radiotherapy of laryngeal cancer

Bartoň, Michael; Keane, Thomas J.; Gadalla, T.; Maki, Ellen

doi:10.1016/0167-8140(92)90323-m

Cited by 208 publications

(76 citation statements)

References 27 publications

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“…The analysis of causes of radiation failure in retrospective series of patients with head and neck cancer and cervix cancer, suggests a loss of local control as the overall treatment time increases for the same total dose [1,4,22,33,45,53]. This is attributed to tumor cell proliferation during fractionated radiotherapy.…”

Section: Introductionmentioning

confidence: 99%

The value of pretreatment cell kinetic parameters as predictors for radiotherapy outcome in head and neck cancer: a multicenter analysis

Begg

Haustermans

Hart

et al. 1999

Radiotherapy and Oncology

133

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Purpose: The aim of this study was to assess the potential of pre-treatment cell kinetic parameters to predict outcome in head and neck cancer patients treated by conventional radiotherapy.Materials and methods: Data from 11 different centers were pooled. Inclusion criteria were such that the patients received radiotherapy alone, and that the radiotherapy was given in an overall time of at least 6 weeks with a dose of at least 60 Gy. All patients received a tracer dose of either iododeoxyuridine (IdUrd) or bromodeoxyuridine (BrdUrd) intravenously prior to treatment and a tumor biopsy was taken several hours later. The cell kinetic parameters labeling index (LI), DNA synthesis time (Ts) and potential doubling time (Tpot) were subsequently calculated from¯ow cytometry data, obtained on the biopsies using antibodies against I/BrdUrd incorporated into DNA. Each center carried out their own¯ow cytometry analysis.Results: From the 11 centers, a total of 476 patients conforming to the inclusion criteria were analyzed. Median values for overall time and total dose were 49 days and 69 Gy, respectively. Fifty one percent of patients had local recurrences and 53% patients had died, the majority from their disease. Median follow-up was 20 months; being 30 months for surviving patients. Multivariate analysis revealed that T-stage, maximum tumor diameter, differentiation grade, N-stage, tumor localization and overall time correlated with locoregional control, in decreasing order of signi®cance. For the cell kinetic parameters, univariate analysis showed that only LI was signi®cantly associated with local control (P 0:02), with higher values correlating with a worse outcome. Ts showed some evidence that patients with longer values did worse, but this was not signi®cant (P 0:06). Tpot showed no trend (P 0:8). When assessing survival in a univariate analysis, neither LI nor Tpot associated with outcome (P 0:4, 0.4, respectively). Surprisingly, Ts did correlate with survival, with longer values being worse (P 0:02). In the multivariate analysis of local control, LI lost its signi®cance (P 0:16). Conclusions: The only pretreatment kinetic parameter for which some evidence was found for an association with local control (the best end-point for testing the present hypothesis) was LI, not Tpot, and this evidence disappeared in a multivariate analysis. It therefore appears that pretreatment cell kinetic measurements carried out using¯ow cytometry, only provide a relatively weak predictor of outcome after radiotherapy in head and neck cancer. q

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Section: Introductionmentioning

confidence: 99%

The value of pretreatment cell kinetic parameters as predictors for radiotherapy outcome in head and neck cancer: a multicenter analysis

Begg

Haustermans

Hart

et al. 1999

Radiotherapy and Oncology

133

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show abstract

“…Loss of local control with increasing overall treatment time has demonstrated the importance of tumor cell proliferation in patients with head and neck and cervical cancer who are treated with radiotherapy (13)(14)(15)(16)(17). Continuous hyperfractionated accelerated radiotherapy (CHART) has shown that by reducing the overall treatment time, a significant gain can be obtained for non-small cell lung cancer (18).…”

Section: Introductionmentioning

confidence: 99%

Dynamics of Hypoxia, Proliferation and Apoptosis after Irradiation in a Murine Tumor Model

et al. 2006

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“…In patients with T2 tumours the results are less favourable. Thus, local control is reported between 60 and 85% (5,10,15,20,23,(24)(25)(26) and survival after salvage surgery between 80 and 94%…”

Section: Discussionmentioning

confidence: 99%

“…In the univariate analysis a treatment interruption of 7 days or more showed a significant impact, but this was lost in the multivariate analysis. Several authors have shown total treatment time to predict treatment outcome and therefore treatment interruptions are not recommended (16,18,22,24,25,27).…”

Section: Discussionmentioning

confidence: 99%

Primary Radiotherapy of Tl and T2 Glottic Carcinoma: Analysis of treatment results and prognostic factors in 223 patients

et al. 1996

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The effect of treatment time and treatment interruption on tumour control following radical radiotherapy of laryngeal cancer

Cited by 208 publications

References 27 publications

The value of pretreatment cell kinetic parameters as predictors for radiotherapy outcome in head and neck cancer: a multicenter analysis

The value of pretreatment cell kinetic parameters as predictors for radiotherapy outcome in head and neck cancer: a multicenter analysis

Dynamics of Hypoxia, Proliferation and Apoptosis after Irradiation in a Murine Tumor Model

Primary Radiotherapy of Tl and T2 Glottic Carcinoma: Analysis of treatment results and prognostic factors in 223 patients

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