Analysis of Prognostic Variables among Patients with Locally Advanced Head and Neck Cancer Treated with Late Chemo-Intensification Protocol: Impact of Nodal Density and Total Tumor Volume
| Autor: | M.L.B. Bhatt, Kirti Srivastava, Mohan C. Pant, Madhu Srivastava, Kundan S. Chufal, Madhup Rastogi |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Oncology Cancer Research medicine.medical_specialty medicine.medical_treatment Urology Disease-Free Survival Drug Administration Schedule Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Mucositis Humans Radiology Nuclear Medicine and imaging Stage (cooking) Survival rate Aged Neoplasm Staging Cancer staging business.industry Dose fractionation General Medicine Middle Aged Prognosis medicine.disease Combined Modality Therapy Chemotherapy regimen Tumor Burden Survival Rate Radiation therapy Regimen Head and Neck Neoplasms Carcinoma Squamous Cell Female Dose Fractionation Radiation Fluorouracil Cisplatin business |
| Zdroj: | Japanese Journal of Clinical Oncology. 36:537-546 |
| ISSN: | 1465-3621 0368-2811 |
| DOI: | 10.1093/jjco/hyl081 |
| Popis: | Objective The aim of the present study was to define the prognostic impact of nodal density (ND) and total tumor volume along with many other tumor, treatment and patient related variables using the late chemo-intensification treatment regimen with conventionally fractionated radiotherapy (70 Gy/7 weeks). Methods A total of 74 patients with Stage III and IV biopsy proven squamous cell carcinoma of oropharynx, hypopharynx and larynx were treated with this regimen. ND and total tumor volume was measured on high resolution CT scans for all the patients. Chemotherapy consisted of continuous infusion of 5 FU at 350 mg/m(2)/day and cisplatin as 1 h infusion at 10 mg/m(2)/day on days 1-5 of week 6 and 7 of radiotherapy. Results Grade III mucositis was present in 48 (64.9%) patients. Overall complete response rate was 77%. At 28 months, locoregional relapse-free survival (LRFS), overall survival (OS) and distant metastases-free survival (DMFS) was 70.8%, 66.9% and 81.9%, respectively. In the final multivariate Cox-regression model tumor stage, ND, primary site and nodal stage were independent variables predicting for LRFS. Similarly AJCC group staging, ND and total treatment volume were found to have significant impact, independently over LRFS. Conclusions There is tremendous variation in terms of ND and total tumor volume within AJCC nodal staging and tumor staging, respectively. ND had significant impact over LRFS and OS. Future phase III trial may need stratification on the basis of these variables. |
| Databáze: | OpenAIRE |
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