Very accelerated radiotherapy or concurrent chemoradiotherapy for N3 head and neck squamous cell carcinoma: Pooled analysis of two GORTEC randomized trials.

Details

Serval ID
serval:BIB_29331300F68D
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Very accelerated radiotherapy or concurrent chemoradiotherapy for N3 head and neck squamous cell carcinoma: Pooled analysis of two GORTEC randomized trials.
Journal
Oral oncology
Author(s)
Tao Y., Aupérin A., Graff P., Lapeyre M., Grégoire V., Maingon P., Geoffrois L., Verrelle P., Calais G., Gery B., Martin L., Alfonsi M., Deprez P., Bardet E., Pignon T., Rives M., Sire C., Bourhis J.
ISSN
1879-0593 (Electronic)
ISSN-L
1368-8375
Publication state
Published
Issued date
08/2017
Peer-reviewed
Oui
Volume
71
Pages
61-66
Language
english
Notes
Publication types: Clinical Trial, Phase III ; Journal Article ; Randomized Controlled Trial
Publication Status: ppublish
Abstract
To analyze the outcome of N3 patients treated with very accelerated radiotherapy (VART) or different schedules of concurrent chemoradiotherapy (CRT) within two phase III trials.
Data of 179 patients with N3 HNSCC from two GORTEC randomized trials (96-01 and 99-02) were pooled. Patients received either VART: 64.8Gy/3.5weeks or one of the 3 following CRT regimens: Conventional CRT: 70Gy/7weeks+3 cycles carboplatin-5FU; Moderately accelerated CRT: 70Gy/6weeks+2 cycles carboplatin-5FU; Strongly intensified CRT: 64Gy/5weeks+cisplatin (days 2, 16, 30) and 5 FU (days 1-5, 29-33) followed by 2 cycles adjuvant cisplatin-5FU.
Median follow-up was 13.3 and 5.2years for GORTEC 96-01 and GORTEC 99-02, respectively. Five-year overall survival (OS) was 13.8%. No significant difference was observed between CRT versus VART in terms of OS (hazard ratio [HR]: 0.93, p=0.68), loco-regional progression (HR: 0.70, p=0.13), or distant progression (HR: 0.86, p=0.53). OS was worse for patients with T3-4 tumors versus early T stage (11.0% versus 25.7%, p=0.015). In multivariate analysis, the oropharyngeal subsite presented a higher risk of distant metastasis (as first event 46.5% vs 19.2%, p<0.001),). A significant interaction between treatment modalities and subsites has been observed concerning loco-regional and distant failures.
The outcome of N3 HNSCC was extremely poor despite treatment intensification and no difference between CRT and VART. Both distant metastases and loco-regional failures remain important treatment challenge.

Keywords
Antineoplastic Combined Chemotherapy Protocols/therapeutic use, Carboplatin/administration & dosage, Carcinoma, Squamous Cell/drug therapy, Carcinoma, Squamous Cell/pathology, Carcinoma, Squamous Cell/radiotherapy, Carcinoma, Squamous Cell/therapy, Chemoradiotherapy, Cisplatin/administration & dosage, Disease Progression, Female, Fluorouracil/administration & dosage, Head and Neck Neoplasms/drug therapy, Head and Neck Neoplasms/pathology, Head and Neck Neoplasms/radiotherapy, Head and Neck Neoplasms/therapy, Humans, Male, Middle Aged, Neoplasm Metastasis, Prognosis, Survival Analysis, Accelerated radiotherapy, Concurrent chemoradiotherapy, Distant metastasis, Head and neck cancer, N3, Oropharyngeal cancer
Pubmed
Web of science
Create date
04/08/2017 12:45
Last modification date
20/08/2019 13:08
Usage data