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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 [OPEN ACCESS]
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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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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)
Treatment modification
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