Long-term outcome and patterns of failure in patients with advanced head and neck cancer.

Détails

Ressource 1Télécharger: BIB_FCA57C9762D8.P001.pdf (307.79 [Ko])
Etat: Public
Version: de l'auteur
ID Serval
serval:BIB_FCA57C9762D8
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Long-term outcome and patterns of failure in patients with advanced head and neck cancer.
Périodique
Radiation Oncology
Auteur(s)
Hauswald H., Simon C., Hecht S., Debus J., Lindel K.
ISSN
1748-717X (Electronic)
ISSN-L
1748-717X
Statut éditorial
Publié
Date de publication
2011
Volume
6
Numéro
70
Pages
1-7
Langue
anglais
Notes
Publication types: Journal Article Publication Status: epublish. PDF type: Research
Résumé
PURPOSE: To access the long-time outcome and patterns of failure in patients with advanced head and neck squamous cell carcinoma (HNSCC).
METHODS AND MATERIALS: Between 1992 and 2005 127 patients (median age 55 years, UICC stage III n=6, stage IV n=121) with primarily inoperable, advanced HNSCC were treated with definite platinum-based radiochemotherapy (median dose 66.4 Gy). Analysed end-points were overall survival (OS), disease-free survival (DFS), loco-regional progression-free survival (LPFS), development of distant metastases (DM), prognostic factors and causes of death.
RESULTS: The mean follow-up time was 34 months (range, 3-156 months), the 3-, 5- and 10-year OS rates were 39%, 28% and 14%, respectively. The median OS was 23 months. Forty-seven patients achieved a complete remission and 78 patients a partial remission. The median LPFS was 17 months, the 3-, 5- and 10-year LPFS rates were 41%, 33% and 30%, respectively. The LPFS was dependent on the nodal stage (p=0.029). The median DFS was 11 months (range, 2-156 months), the 3-, 5- and 10-year DFS rates were 30%, 24% and 22%, respectively. Prognostic factors in univariate analyses were alcohol abuse (n=102, p=0.015), complete remission (n=47, p<0.001), local recurrence (n=71, p<0.001), development of DM (n=45, p<0.001; median OS 16 months) and borderline significance in nodal stage N2 versus N3 (p=0.06). Median OS was 26 months with lung metastases (n=17). Nodal stage was a predictive factor for the development of DM (p=0.025). Cause of death was most commonly tumor progression.
CONCLUSIONS: In stage IV HNSCC long-term survival is rare and DM is a significant predictor for mortality. If patients developed DM, lung metastases had the most favourable prognosis, so intensified palliative treatment might be justified in DM limited to the lungs.
Mots-clé
Adult, Aged, Carcinoma, Squamous Cell/drug therapy, Carcinoma, Squamous Cell/mortality, Combined Modality Therapy/methods, Disease Progression, Disease-Free Survival, Dose-Response Relationship, Drug, Dose-Response Relationship, Radiation, Female, Follow-Up Studies, Head and Neck Neoplasms/drug therapy, Head and Neck Neoplasms/mortality, Humans, Male, Middle Aged, Neoplasm Metastasis, Prognosis, Remission Induction, Treatment Outcome
Pubmed
Web of science
Open Access
Oui
Création de la notice
04/06/2013 9:57
Dernière modification de la notice
20/08/2019 17:27
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