Matched survival analysis in patients with locoregionally advanced resectable oropharyngeal carcinoma: platinum-based induction and concurrent chemoradiotherapy versus primary surgical resection
Autor: | Vittorio Baggio, Stefano Lamon, Marco Stellin, Paolo Boscolo-Rizzo, Carlo Marchiori, Roberto Fuson, Maria Cristina Da Mosto, Alessandro Gava |
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Přispěvatelé: | BOSCOLO RIZZO, Paolo, Gava, A, Baggio, V, Marchiori, C, Stellin, M, Fuson, R, Lamon, S, DA MOSTO, MARIA CRISTINA |
Jazyk: | angličtina |
Rok vydání: | 2011 |
Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty Matched-Pair Analysis Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Radiology Nuclear Medicine and imaging Prospective Studies Prospective cohort study Survival rate Survival analysis Aged Proportional Hazards Models Radiation business.industry Proportional hazards model Remission Induction Hazard ratio Induction chemotherapy Radiotherapy Dosage Middle Aged Combined Modality Therapy Survival Analysis Surgery Survival Rate Oropharyngeal Neoplasms Regimen Carcinoma Squamous Cell Female Fluorouracil Cisplatin business Chemoradiotherapy |
Popis: | Purpose The outcome of a prospective case series of 47 patients with newly diagnosed resectable locoregionally advanced oropharyngeal squamous cell carcinoma treated with platinum-based induction-concurrent chemoradiotherapy (IC/CCRT) was compared with the outcome of 47 matched historical control patients treated with surgery and postoperative RT. Methods and Materials A total of 47 control patients with locoregionally advanced oropharyngeal squamous cell carcinoma were identified from review of a prospectively compiled comprehensive computerized head-and-neck cancer database and were matched with a prospective case series of patients undergoing IC/CCRT by disease stage, nodal status, gender, and age (±5 years). The IC/CCRT regimen consisted of one cycle of induction chemotherapy followed by conventionally fractionated RT to a total dose of 66–70 Gy concomitantly with two cycles of chemotherapy. Each cycle of chemotherapy consisted of cisplatinum, 100 mg/m 2 , and a continuous infusion of 5-fluorouracil, 1,000 mg/m 2 /d for 5 days. The survival analysis was performed using Kaplan-Meier estimates. Matched-pair survival was compared using the Cox proportional hazards model. Results No significant difference was found in the overall survival or progression-free survival rates between the two groups. The matched analysis of survival did not show a statistically significant greater hazard ratio for overall death (hazard ratio, 1.35; 95% confidence interval, 0.65–2.80; p = .415) or progression (hazard ratio, 1.44; 95% confidence interval, 0.72–2.87; p = .301) for patients undergoing IC/CCRT. Conclusion Although the sample size was small and not randomized, this matched-pair comparison between a prospective case series and a historical cohort treated at the same institution showed that the efficacy of IC/CCRT with salvage surgery is as good as primary surgical resection and postoperative RT. |
Databáze: | OpenAIRE |
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