Hyperfractionated Accelerated Radiotherapy versus Conventional Fractionation Both Combined with Chemotherapy in Patients with Locally Advanced Head and Neck Carcinomas
Objective: Hyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from randomized trials are available for a comparison with conventionally fractionated radiotherapy (CFRT) and CC. Methods: This monoinstitutio...
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| Veröffentlicht in: | Oncology 2009-06, Vol.76 (6), p.405-412 |
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| creator | Welz, Hanna Pöttgen, Christoph Abu Jawad, Jehad Wierlemann, Arne Wittig, Andrea Stüben, Georg Budach, Volker Lehnerdt, Goetz Jahnke, Klaus Sack, Horst Stuschke, Martin |
| description | Objective: Hyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from randomized trials are available for a comparison with conventionally fractionated radiotherapy (CFRT) and CC. Methods: This monoinstitutional retrospective study compares the results of both treatment schedules: 315 patients with locally advanced carcinoma (UICC stage III and IV) of the oral cavity and the orohypopharynx were treated from January 1990 to March 2006 with a radiochemotherapy combination based on mitomycin C and fluorouracil (HART-CC: 203 patients, CFRT-CC: 112 patients, total dose: 70–72 Gy) with curative intent. Results: Two- and 4-year survival was 60 and 42 (HART-CC) and 59 and 42% (CFRT-CC; p = 0.82, log-rank test), respectively. Using multivariate Cox regression, pretreatment hemoglobin level, N stage, tumor site but not the year of treatment, gender and T stage were significant prognosticators for survival. For locoregional control, only N stage was significant. The prognostic value of these pretreatment factors did not variate with the fractionation schedule used. Conclusions: In combination with CC, there was no trend towards an improved efficacy of HART in comparison with CFRT. |
| doi_str_mv | 10.1159/000215927 |
| format | Article |
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Methods: This monoinstitutional retrospective study compares the results of both treatment schedules: 315 patients with locally advanced carcinoma (UICC stage III and IV) of the oral cavity and the orohypopharynx were treated from January 1990 to March 2006 with a radiochemotherapy combination based on mitomycin C and fluorouracil (HART-CC: 203 patients, CFRT-CC: 112 patients, total dose: 70–72 Gy) with curative intent. Results: Two- and 4-year survival was 60 and 42 (HART-CC) and 59 and 42% (CFRT-CC; p = 0.82, log-rank test), respectively. Using multivariate Cox regression, pretreatment hemoglobin level, N stage, tumor site but not the year of treatment, gender and T stage were significant prognosticators for survival. For locoregional control, only N stage was significant. The prognostic value of these pretreatment factors did not variate with the fractionation schedule used. Conclusions: In combination with CC, there was no trend towards an improved efficacy of HART in comparison with CFRT.</description><identifier>ISSN: 0030-2414</identifier><identifier>EISSN: 1423-0232</identifier><identifier>DOI: 10.1159/000215927</identifier><identifier>PMID: 19407473</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Chemotherapy ; Clinical Study ; Comparative studies ; Head & neck cancer ; Oncology ; Radiation therapy</subject><ispartof>Oncology, 2009-06, Vol.76 (6), p.405-412</ispartof><rights>2009 S. Karger AG, Basel</rights><rights>Copyright (c) 2009 S. Karger AG, Basel</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c1577-c3bd79b4b5350ab9499ee53ec1746bdfda07043685321ea7033d7cd3cc8cce203</citedby><cites>FETCH-LOGICAL-c1577-c3bd79b4b5350ab9499ee53ec1746bdfda07043685321ea7033d7cd3cc8cce203</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2429,27924,27925</link.rule.ids></links><search><creatorcontrib>Welz, Hanna</creatorcontrib><creatorcontrib>Pöttgen, Christoph</creatorcontrib><creatorcontrib>Abu Jawad, Jehad</creatorcontrib><creatorcontrib>Wierlemann, Arne</creatorcontrib><creatorcontrib>Wittig, Andrea</creatorcontrib><creatorcontrib>Stüben, Georg</creatorcontrib><creatorcontrib>Budach, Volker</creatorcontrib><creatorcontrib>Lehnerdt, Goetz</creatorcontrib><creatorcontrib>Jahnke, Klaus</creatorcontrib><creatorcontrib>Sack, Horst</creatorcontrib><creatorcontrib>Stuschke, Martin</creatorcontrib><title>Hyperfractionated Accelerated Radiotherapy versus Conventional Fractionation Both Combined with Chemotherapy in Patients with Locally Advanced Head and Neck Carcinomas</title><title>Oncology</title><addtitle>Oncology</addtitle><description>Objective: Hyperfractionated accelerated radiotherapy (HART) has been combined with chemotherapy (CC) for locally advanced head and neck cancer, but no data from randomized trials are available for a comparison with conventionally fractionated radiotherapy (CFRT) and CC. Methods: This monoinstitutional retrospective study compares the results of both treatment schedules: 315 patients with locally advanced carcinoma (UICC stage III and IV) of the oral cavity and the orohypopharynx were treated from January 1990 to March 2006 with a radiochemotherapy combination based on mitomycin C and fluorouracil (HART-CC: 203 patients, CFRT-CC: 112 patients, total dose: 70–72 Gy) with curative intent. Results: Two- and 4-year survival was 60 and 42 (HART-CC) and 59 and 42% (CFRT-CC; p = 0.82, log-rank test), respectively. Using multivariate Cox regression, pretreatment hemoglobin level, N stage, tumor site but not the year of treatment, gender and T stage were significant prognosticators for survival. For locoregional control, only N stage was significant. The prognostic value of these pretreatment factors did not variate with the fractionation schedule used. Conclusions: In combination with CC, there was no trend towards an improved efficacy of HART in comparison with CFRT.</description><subject>Chemotherapy</subject><subject>Clinical Study</subject><subject>Comparative studies</subject><subject>Head & neck cancer</subject><subject>Oncology</subject><subject>Radiation therapy</subject><issn>0030-2414</issn><issn>1423-0232</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNo9kUtPwkAUhSdGI4gu3LuYuHNRnVeZdomNiAlRY3TdTGdupVA6OAOY_iL_pgMlbO4j5zsnubkIXVNyT2mcPhBCWOhMnqA-FYxHhHF2ivqEcBIxQUUPXXg_D5iMxfAc9WgqiBSS99HfpF2BK53S68o2ag0Gj7SGGtx-_lCmsutZ2FYt3oLzG48z22yh2eM1Hh-doeDHwAZ9WVRNMP9Wu20Gy2NC1eD3QAa379Sp1aquWzwyW9Xo4JmAMlg1Br-CXuBMOV01dqn8JTorVe3h6tAH6Gv89JlNounb80s2mkaaxlJGmhdGpoUoYh4TVaQiTQFiDppKMSxMaRSRRPBhEnNGQUnCuZHacK2TcDUjfIBuu9yVsz8b8Ot8bjcuXOpzxkiScM7TAN11kHbWewdlvnLVUrk2pyTffSQ_fiSwNx27UO4b3JE8yP_DRohL</recordid><startdate>200906</startdate><enddate>200906</enddate><creator>Welz, Hanna</creator><creator>Pöttgen, Christoph</creator><creator>Abu Jawad, Jehad</creator><creator>Wierlemann, Arne</creator><creator>Wittig, Andrea</creator><creator>Stüben, Georg</creator><creator>Budach, Volker</creator><creator>Lehnerdt, Goetz</creator><creator>Jahnke, Klaus</creator><creator>Sack, Horst</creator><creator>Stuschke, Martin</creator><general>S. 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Methods: This monoinstitutional retrospective study compares the results of both treatment schedules: 315 patients with locally advanced carcinoma (UICC stage III and IV) of the oral cavity and the orohypopharynx were treated from January 1990 to March 2006 with a radiochemotherapy combination based on mitomycin C and fluorouracil (HART-CC: 203 patients, CFRT-CC: 112 patients, total dose: 70–72 Gy) with curative intent. Results: Two- and 4-year survival was 60 and 42 (HART-CC) and 59 and 42% (CFRT-CC; p = 0.82, log-rank test), respectively. Using multivariate Cox regression, pretreatment hemoglobin level, N stage, tumor site but not the year of treatment, gender and T stage were significant prognosticators for survival. For locoregional control, only N stage was significant. The prognostic value of these pretreatment factors did not variate with the fractionation schedule used. 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| identifier | ISSN: 0030-2414 |
| ispartof | Oncology, 2009-06, Vol.76 (6), p.405-412 |
| issn | 0030-2414 1423-0232 |
| language | eng |
| recordid | cdi_karger_primary_215927 |
| source | Karger Journals; Alma/SFX Local Collection |
| subjects | Chemotherapy Clinical Study Comparative studies Head & neck cancer Oncology Radiation therapy |
| title | Hyperfractionated Accelerated Radiotherapy versus Conventional Fractionation Both Combined with Chemotherapy in Patients with Locally Advanced Head and Neck Carcinomas |
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