Mature results from a Swedish comparison study of conventional versus accelerated radiotherapy in head and neck squamous cell carcinoma - The ARTSCAN trial
Autor: | Lars Franzén, Anders Ask, Karin Söderström, Jan Nyman, Helena Sjödin, Erik Lundin, Karl-Axel Johansson, Gun Wickart-Johansson, Elisabeth Kjellén, Johan Wennerberg, Eva Brun, Signe Friesland, Britta Lödén, Freddi Lewin, Per Nilsson, Tina Dalianis, Lars Ekberg, Thomas Björk-Eriksson, Björn Zackrisson, Johan Reizenstein |
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Rok vydání: | 2015 |
Předmět: |
Oncology
Adult Male medicine.medical_specialty medicine.medical_treatment Internal medicine medicine Humans Radiology Nuclear Medicine and imaging Aged Neoplasm Staging Retrospective Studies Aged 80 and over Human papillomavirus 16 business.industry Squamous Cell Carcinoma of Head and Neck Papillomavirus Infections Dose fractionation Retrospective cohort study Hematology Middle Aged medicine.disease Prognosis Head and neck squamous-cell carcinoma Radiation therapy Oropharyngeal Neoplasms Oropharyngeal Neoplasm Head and Neck Neoplasms Accelerated radiotherapy Comparison study Carcinoma Squamous Cell Female Dose Fractionation Radiation business Oropharyngeal Cancers |
Zdroj: | Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology. 117(1) |
ISSN: | 1879-0887 |
Popis: | 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.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.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.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. |
Databáze: | OpenAIRE |
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