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SHR Neuro Krebs Kardio Lipid

Mollnar, S; Pondorfer, P; Kasparek, AK; Reinisch, S; Moik, F; Stotz, M; Halm, M; Szkandera, J; Terbuch, A; Eisner, F; Gerger, A; Kapp, KS; Partl, R; Vasicek, S; Weiland, T; Pichler, M; Stöger, H; Thurnher, D; Posch, F.
Decrease in treatment intensity predicts worse outcome in patients with locally advanced head and neck squamous cell carcinoma undergoing radiochemotherapy.
Clin Transl Oncol. 2020;
Web of Science PubMed FullText FullText_MUG

 

Autor/innen der Med Uni Graz:
Eisner Florian
Gerger Armin
Halm Michael
Kapp Karin S.
Kasparek Anne-Katrin
Partl Richard
Pichler Martin
Pondorfer-Schäfer Prisca
Posch Florian
Reinisch Sabine
Stoeger Herbert
Stotz Michael
Szkandera Joanna
Terbuch Angelika
Thurnher Dietmar
Vasicek Sarah Marvis
Weiland Thomas
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Abstract:
Radiochemotherapy (RCT) is an effective standard therapy for locally advanced head and neck squamous cell carcinoma (LA-HNSCC). Nonetheless, toxicity is common, with patients often requiring dose modifications. To investigate associations of RCT toxicities according to CTCAE version 5.0 and subsequent therapy modifications with short- and long-term treatment outcomes, we studied all 193 patients with HNSCC who received RCT (70 Gy + platinum agent) at an academic center between 03/2010 and 04/2018. During RCT, 77 (41%, 95% CI 34-49) patients developed at least one ≥ grade 3 toxicity, including seven grade 4 and 3 fatal grade 5 toxicities. The most frequent any-grade toxicities were xerostomia (n = 187), stomatitis (n = 181), dermatitis (n = 174), and leucopenia (n = 98). Eleven patients (6%) had their radiotherapy schedule modified (mean radiotherapy dose reduction = 12 Gy), and 120 patients (64%) had chemotherapy modifications (permanent discontinuation: n = 67, pause: n = 34, dose reduction: n = 7, change to other chemotherapy: n = 10). Objective response rates to RCT were 55% and 88% in patients with and without radiotherapy modifications (p = 0.003), and 84% and 88% in patients with and without chemotherapy modifications (p = 0.468), respectively. Five-year progression-free survival estimates were 20% and 50% in patients with and without radiotherapy modifications (p = < 0.001), and 53% and 40% in patients with and without chemotherapy modifications (p = 0.88), respectively. Reductions of radiotherapy dose were associated with impaired long-term outcomes, whereas reductions in chemotherapy intensity were not. This suggests that toxicities during RCT should be primarily managed by modifying chemotherapy rather than radiotherapy.

Find related publications in this database (Keywords)
HNSCC
Radiochemotherapy
Toxicity
Treatment modification
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