Advanced Head and Neck Cancer: Long-Term Results of Chemo-Radiotherapy, Complications and Induction of Second Malignancies
| Autor: | R. Hartenstein, L. Purmale, H. Pohlmann, R. Munker, M. Reitmeier, H. Schorer, Ü. Aydemir |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
Cancer Research medicine.medical_specialty Neoplasms Radiation-Induced Mitomycin Population Leucovorin Disease-Free Survival Folinic acid Antineoplastic Combined Chemotherapy Protocols medicine Humans Cobalt Radioisotopes Radiation Injuries Lung cancer education Survival rate Aged Neoplasm Staging education.field_of_study business.industry Head and neck cancer Dose fractionation Neoplasms Second Primary Hematology Middle Aged medicine.disease Combined Modality Therapy Surgery Survival Rate Otorhinolaryngologic Neoplasms Oncology Relative risk Female Dose Fractionation Radiation Fluorouracil Cisplatin Radioisotope Teletherapy Skin cancer business Follow-Up Studies medicine.drug |
| Zdroj: | Oncology Research and Treatment. 24:553-558 |
| ISSN: | 2296-5262 2296-5270 |
| Popis: | Background: Chemo-radiotherapy is superior to radiotherapy alone in the treatment of advanced, inoperable head and neck cancer. The long-term treatment results, the induction of second malignant tumors, and other long-term toxicities are not well defined. Patients and Methods: 100 consecutive patients with advanced head and neck cancer who were treated at our center were studied. Treatment results, survival, the occurrence of late complications, and second malignant tumors (SMT) were investigated. 78 patients were treated with a protocol combining cisplatinum, 5-fluorouracil, folinic acid and hyperfractionated irradiation. 22 patients were treated with other chemo-radiotherapy protocols. The relative risk of developing an SMT was compared with that within the normal population. Results: The cumulative total probability of survival was 51.1% at 2 years and 38.7% at 4 years. The probability of relapse-free survival was 39.9% at 2 years and 36.7% at 4 years. A total of 7 patients developed SMT (4 cases of lung cancer, 2 colon cancers, 1 skin cancer). After 6 years, a cumulative risk of SMT of 8.7% was observed. The relative risk of developing an SMT was significantly increased (4.45-fold in males) compared with a normal population. 13 of 38 evaluable patients (34.2%) had severe late complications like fibrosis of soft tissues, nerve lesions, or were dependent on tracheal cannulas. Conclusions: The treatment results and long-term prognoses in our population of unselected high-risk patients are unsatisfactory, but comparable to those from multicenter studies. About 35% of patients become long-term (> 4 years) survivors. SMT generally occur early, have a poor prognosis and, most likely, are not treatment-related. Approximately 30% of long-term survivors have severe, often incapacitating late effects. The treatment and – if possible – prevention of these late effects is important for the quality of life of patients who survived advanced head and neck cancer. |
| Databáze: | OpenAIRE |
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