Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
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. 2021; 23(3):543-553
Doi: 10.1007/s12094-020-02447-y
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- Führende Autor*innen der Med Uni Graz
- Posch Florian
- Co-Autor*innen der Med Uni Graz
- Eisner Florian
- Gerger Armin
- Halm Michael
- Kapp Karin S.
- Kasparek Anne-Katrin
- Moik Florian
- Partl Richard
- Pichler Martin
- Pondorfer-Schäfer Prisca
- Reinisch Sabine
- Stöger Herbert
- Stotz Michael
- Szkandera Joanna
- Terbuch Angelika
- Thurnher Dietmar
- Vasicek Sarah Marvis
- Weiland Thomas
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- Abstract:
- PURPOSE: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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 (using NLM MeSH Indexing)
- Aged - administration & dosage
- Carboplatin - adverse effects, therapeutic use
- Chemoradiotherapy - adverse effects, methods
- Cisplatin - adverse effects, therapeutic use
- Dermatitis - etiology
- Female - administration & dosage
- Head and Neck Neoplasms - mortality, pathology, therapy
- Humans - administration & dosage
- Induction Chemotherapy - adverse effects, statistics & numerical data
- Leukopenia - etiology
- Middle Aged - administration & dosage
- Progression-Free Survival - administration & dosage
- Radiation-Sensitizing Agents - adverse effects, therapeutic use
- Radiotherapy Dosage - administration & dosage
- Radiotherapy, Intensity-Modulated - adverse effects, methods
- Retrospective Studies - administration & dosage
- Squamous Cell Carcinoma of Head and Neck - mortality, pathology, therapy
- Stomatitis, Aphthous - etiology
- Treatment Outcome - administration & dosage
- Xerostomia - etiology
- Find related publications in this database (Keywords)
- HNSCC
- Radiochemotherapy
- Toxicity
- Treatment modification