Prognostic factor analysis and long-term results of the TAX 323 (EORTC 24971) study in unresectable head and neck cancer patients
Autor: | Carla M.L. van Herpen, Marie Vinches, Catherine Fortpied, Éva Remenár, Petr Szturz, Cyril Abdeddaim, John S. Stewart, Jan B. Vermorken |
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Rok vydání: | 2021 |
Předmět: |
Male
Cancer Research medicine.medical_specialty Time Factors Databases Factual medicine.medical_treatment Docetaxel Gastroenterology Risk Assessment Risk Factors Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Feeding tube Aged Retrospective Studies business.industry Squamous Cell Carcinoma of Head and Neck Head and neck cancer Hazard ratio Induction chemotherapy Middle Aged medicine.disease Dysphagia Progression-Free Survival Radiation therapy Europe Oncology Clinical Trials Phase III as Topic Head and Neck Neoplasms Disease Progression Female Human medicine Fluorouracil medicine.symptom Cisplatin business PF Regimen Rare cancers Radboud Institute for Health Sciences [Radboudumc 9] medicine.drug |
Zdroj: | European Journal of Cancer, 156, 109-118 European Journal of Cancer, 156, pp. 109-118 European journal of cancer |
ISSN: | 1879-0852 0959-8049 |
Popis: | Contains fulltext : 238276.pdf (Publisher’s version ) (Closed access) BACKGROUND: In the TAX 323 (EORTC 24971) phase III trial enrolling patients with unresectable locoregionally advanced squamous cell carcinoma of the head and neck (LA-SCCHN), the addition of docetaxel (T) to cisplatin and 5-fluorouracil (PF)-based induction chemotherapy prior to definite radiotherapy significantly improved progression-free survival (PFS) and overall survival (OS). METHODS: The data were updated for PFS, OS and treatment-related long-term side-effects. Baseline clinical and laboratory data of 17 variables were collected and subjected to univariate and multivariate prognostic factor analyses for OS. RESULTS: All 358 patients randomised between 1999 and 2002 were included in the long-term analysis with a median follow-up of 8.6 years. The primary end-point of PFS remained significantly improved with TPF compared with PF (adjusted hazard ratio [HR], 0.70; 95% CI, 0.56-0.88, p = 0.002), translating into a persisting benefit in OS (adjusted HR, 0.75; 95% CI, 0.60-0.95, p = 0.015). Long-term side-effects in the TPF/PF arms comprised tracheostomy (7%/5%), feeding tube dependency (3%/6%) and gastrostomy (11%/11%). Second malignancy occurred in 8%/3%, respectively. Out of 177 patients randomised to the TPF arm, 160 were included in the multivariate analysis. Grade 2 or more dysphagia (p = 0.002) and grade 2 or more pain (p = 0.004) at baseline were identified as independent negative prognostic factors. In addition, OS differed across primary tumour sites (p = 0.027) and was worse in patients with a higher N-stage (p = 0.025). CONCLUSIONS: In LA-SCCHN patients treated with sequential chemoradiotherapy, TPF induction chemotherapy demonstrated long-lasting efficacy, superior to the PF regimen. Higher-grade dysphagia and pain are unfavourable prognosticators. |
Databáze: | OpenAIRE |
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