An original accelerated radiotherapy schedule in stage III to IV head and neck cancers. Results in a multicenter setting

Détails

ID Serval
serval:BIB_F25C14EB1FC0
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
An original accelerated radiotherapy schedule in stage III to IV head and neck cancers. Results in a multicenter setting
Périodique
StrahlenThérapie und Onkologie
Auteur(s)
Allal  A. S., Monney  M., Rosset  A., Ozsahin  M., Guillemin  C.
ISSN
0179-7158
Statut éditorial
Publié
Date de publication
01/2000
Peer-reviewed
Oui
Volume
176
Numéro
1
Pages
28-31
Notes
Clinical Trial
Journal Article
Multicenter Study --- Old month value: Jan
Résumé
BACKGROUND: Accelerated radiotherapy delivery has recently been shown to be effective in overcoming repopulation during fractionated radiotherapy. The therapeutic ratio may be particularly favorable for 5-week regimens. This study reports the feasibility and results of a particular accelerated schedule in Stage III to IV head and neck carcinomas used in a multicenter setting. PATIENTS AND METHODS: Seventy-four patients with Stage III (26 patients) or IV (48 patients) head and neck carcinomas were treated with a 5-week accelerated schedule (69.6 to 69.8 Gy in 41 to 40 fractions over a period of 35 to 36 days). Treatment began with 20 Gy in 10 daily fractions to initial involved sites, followed by bi-fractionated radiotherapy (2 x 1.6 Gy to 1.66 Gy/day) to a larger head and neck volume. Thirty-six (49%) patients received induction chemotherapy (median 3 cycles, range 1 to 4 cycles). RESULTS: Grade 3 or 4 (RTOG) confluent mucositis was observed in 57 patients (77%) and Grade 3 dysphagia in 33 patients (44%). Grade 3 or 4 (RTOG-EORTC) late complications were scored in 10.5% of cases. The 5-year actuarial locoregional control rate was 56% (95% CI: 42 to 71). The 5-year overall actuarial survival was 32% (95% CI: 18 to 46). Induction chemotherapy was not associated with a more favorable outcome. CONCLUSIONS: This study demonstrates the feasibility of this schedule in a multicenter setting. The oncologic results appear similar to those obtained by other accelerated regimens, while the rate of late complications seems acceptable. Five-week accelerated regimens warrant further evaluation, particularly in conjunction with concomitant chemotherapy, in the framework of prospective trials.
Mots-clé
Actuarial Analysis Adolescent Adult Aged Aged, 80 and over Antineoplastic Combined Chemotherapy Protocols/therapeutic use Bleomycin/administration & dosage Carcinoma, Squamous Cell/drug therapy/mortality/pathology/radiotherapy Cisplatin/administration & dosage Cyclophosphamide/administration & dosage Dose Fractionation Doxorubicin/administration & dosage Female Fluorouracil/administration & dosage Head and Neck Neoplasms/drug therapy/mortality/pathology/*radiotherapy Humans Male Methotrexate/administration & dosage Middle Aged Neoplasm Staging Patient Selection Prednisone/administration & dosage Radiotherapy/adverse effects Remission Induction Survival Rate Vincristine/administration & dosage
Pubmed
Web of science
Création de la notice
24/01/2008 18:16
Dernière modification de la notice
03/03/2018 22:40
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