Mature results from a Swedish comparison study of conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma - The ARTSCAN trial.

Autor: Zackrisson B; Department of Radiation Sciences - Oncology, Umeå University, Sweden. Electronic address: bjorn.zackrisson@umu.se., Kjellén E; Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Sweden., Söderström K; Department of Radiation Sciences - Oncology, Umeå University, Sweden., Brun E; Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Sweden., Nyman J; Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden., Friesland S; Department of Oncology, Karolinska University Hospital, Stockholm, Sweden., Reizenstein J; Department of Oncology, Örebro University Hospital, Sweden., Sjödin H; Department of Oncology, Karolinska University Hospital, Stockholm, Sweden., Ekberg L; Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Sweden., Lödén B; Department of Oncology, Central Hospital, Karlstad, Sweden., Franzén L; Department of Radiation Sciences - Oncology, Umeå University, Sweden., Ask A; Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Sweden., Wickart-Johansson G; Department of Oncology, Karolinska University Hospital, Stockholm, Sweden., Lewin F; Department of Oncology, Ryhov Hospital, Jönköping, Sweden., Björk-Eriksson T; Department of Oncology, Sahlgrenska University Hospital, Gothenburg, Sweden., Lundin E; Department of Oncology, Örebro University Hospital, Sweden., Dalianis T; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden., Wennerberg J; Department of ORL/Head & Neck Surgery, Skåne University Hospital, Lund, Sweden., Johansson KA; Department of Radiation Physics, Sahlgrenska University Hospital, Gothenburg, Sweden., Nilsson P; Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Sweden.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2015 Oct; Vol. 117 (1), pp. 99-105. Date of Electronic Publication: 2015 Sep 29.
DOI: 10.1016/j.radonc.2015.09.024
Abstrakt: Background and Purpose: This report contains the mature five-year data from the Swedish ARTSCAN trial including information on the influence of p16 positivity (p16+) for oropharyngeal cancers.
Material and Methods: Patients with previously untreated squamous cell carcinoma without distant metastases of the oral cavity, oropharynx, larynx (except T1-2, N0 glottic cancers) and hypopharynx were included. Patients were randomised between accelerated fractionation (AF) (1.1Gy+2Gy per day, 5days/week for 4.5weeks, total dose 68Gy) and conventional fractionation (CF) (2Gy per day, 5days/week for 7weeks, total dose 68Gy). Human papillomavirus (HPV)-associated p16-expression was assessed retrospectively in tumour tissues from patients with oropharyngeal carcinoma.
Results: There was no significant difference in loco-regional control (LRC) between AF and CF (log-rank test p=0.75). LRC at 5years was 65.5% for AF and 64.9% for CF. Overall survival (OS) was similar in both arms (p=0.99). The estimated cancer specific survival (CSS) at 5years was 62.2% (AF) and 63.3% (CF) (p=0.99). 206 specimens were analysed for p16 with 153 specimens (74%) identified as p16+. P16 status did not discriminate for response to AF vs. CF with regard to LRC, OS or CSS. Patients with p16+ tumours had a statistically significant better overall prognosis compared with p16- tumours.
Conclusion: This update confirms the results of the 2-year report. We failed to identify a positive effect resulting from AF with regards to LRC, OS and CSS. The addition of information on the HPV-associated p16 overexpression did not explain this lack of effect.
(Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)
Databáze: MEDLINE
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