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Article: Alternating chemoradiotherapy versus partly accelerated radiotherapy in locally advanced squamous cell carcinoma of the head and neck: Results from a phase III randomized trial

TitleAlternating chemoradiotherapy versus partly accelerated radiotherapy in locally advanced squamous cell carcinoma of the head and neck: Results from a phase III randomized trial
Authors
KeywordsAccelerated radiotherapy
Chemoradiotherapy
Head and neck carcinoma
Randomized clinical trial
Squamous cell carcinoma
Issue Date2001
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741
Citation
Cancer, 2001, v. 92 n. 11, p. 2856-2867 How to Cite?
AbstractBACKGROUND. The authors previously have found that in patients with locally advanced squamous cell carcinoma of the head and neck (SCC-HN), alternating chemoradiotherapy (ALT) was superior to low-total-dose conventional radiotherapy alone. The purpose of this randomized trial was to compare the same chemoradiotherapy approach with high-total-dose partly accelerated radiotherapy. METHODS. During 6 years, 136 consecutive patients with previously untreated unfavorable Stage II or Stage III-IV (International Union Against Cancer) SCC of the oral cavity, pharynx, and larynx were enrolled. They were randomly assigned to chemotherapy consisting of 4 cycles of intravenous cisplatin (20 mg/m2 of body surface area per day for 5 consecutive days) and 5-fluorouracil (200 mg/m2 per day for 5 consecutive days; weeks 1, 4, 7, and 10) alternated with three 2-week courses of radiotherapy (20 grays [Gy] per course, 2 Gy per day, 5 days per week; ALT, 70 patients) or to partly accelerated radiotherapy with final concomitant boost technique (75 Gy/40 fractions in 6 weeks; partly accelerated radiotherapy [PA-RT], 66 patients). RESULTS. At the median follow-up of 60 months (range, 30-102 months), no statistical differences were observed in overall survival, progression free survival, or locoregional control between the 2 treatments. Actuarial 3-year overall survival and progression free survival were 37% and 35%, respectively, in the ALT group and 29% and 27%, respectively, in PA-RT group. The median overall survival and progression free survival were 24 and 15 months, respectively, in the ALT arm and 18 and 11 months, respectively, in PA-RT arm. Actuarial 3-year locoregional control rates were 32% in the ALT group and 27% in the PA-RT group. At multivariate analysis, tumor classification was the only factor that emerged as a significant independent variable affecting overall survival. Patients treated in the PA-RT arm experienced higher Grade 3+ (World Health Organization) acute skin and mucosal reactions than patients in the ALT arm. Moreover, local late mucosal and skin toxicities occurred more often in patients treated with PA-RT. CONCLUSIONS. This trial failed to disclose statistically significant differences in the outcome of patients treated with either ALT or PA-RT. Therefore, definitive conclusions could not be made. However, acute skin effects and late mucosal and skin toxicities above the clavicles appeared to be significantly lower with chemoradiotherapy. © 2001 American Cancer Society.
Persistent Identifierhttp://hdl.handle.net/10722/172796
ISSN
2015 Impact Factor: 5.649
2015 SCImago Journal Rankings: 3.188
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChua, DTTen_HK
dc.contributor.authorSham, JSTen_HK
dc.contributor.authorWei, WIen_HK
dc.contributor.authorHo, WKen_HK
dc.contributor.authorAu, GKHen_HK
dc.date.accessioned2012-10-30T06:24:58Z-
dc.date.available2012-10-30T06:24:58Z-
dc.date.issued2001en_HK
dc.identifier.citationCancer, 2001, v. 92 n. 11, p. 2856-2867en_HK
dc.identifier.issn0008-543Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/172796-
dc.description.abstractBACKGROUND. The authors previously have found that in patients with locally advanced squamous cell carcinoma of the head and neck (SCC-HN), alternating chemoradiotherapy (ALT) was superior to low-total-dose conventional radiotherapy alone. The purpose of this randomized trial was to compare the same chemoradiotherapy approach with high-total-dose partly accelerated radiotherapy. METHODS. During 6 years, 136 consecutive patients with previously untreated unfavorable Stage II or Stage III-IV (International Union Against Cancer) SCC of the oral cavity, pharynx, and larynx were enrolled. They were randomly assigned to chemotherapy consisting of 4 cycles of intravenous cisplatin (20 mg/m2 of body surface area per day for 5 consecutive days) and 5-fluorouracil (200 mg/m2 per day for 5 consecutive days; weeks 1, 4, 7, and 10) alternated with three 2-week courses of radiotherapy (20 grays [Gy] per course, 2 Gy per day, 5 days per week; ALT, 70 patients) or to partly accelerated radiotherapy with final concomitant boost technique (75 Gy/40 fractions in 6 weeks; partly accelerated radiotherapy [PA-RT], 66 patients). RESULTS. At the median follow-up of 60 months (range, 30-102 months), no statistical differences were observed in overall survival, progression free survival, or locoregional control between the 2 treatments. Actuarial 3-year overall survival and progression free survival were 37% and 35%, respectively, in the ALT group and 29% and 27%, respectively, in PA-RT group. The median overall survival and progression free survival were 24 and 15 months, respectively, in the ALT arm and 18 and 11 months, respectively, in PA-RT arm. Actuarial 3-year locoregional control rates were 32% in the ALT group and 27% in the PA-RT group. At multivariate analysis, tumor classification was the only factor that emerged as a significant independent variable affecting overall survival. Patients treated in the PA-RT arm experienced higher Grade 3+ (World Health Organization) acute skin and mucosal reactions than patients in the ALT arm. Moreover, local late mucosal and skin toxicities occurred more often in patients treated with PA-RT. CONCLUSIONS. This trial failed to disclose statistically significant differences in the outcome of patients treated with either ALT or PA-RT. Therefore, definitive conclusions could not be made. However, acute skin effects and late mucosal and skin toxicities above the clavicles appeared to be significantly lower with chemoradiotherapy. © 2001 American Cancer Society.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www3.interscience.wiley.com/cgi-bin/jhome/28741en_HK
dc.relation.ispartofCanceren_HK
dc.subjectAccelerated radiotherapyen_HK
dc.subjectChemoradiotherapyen_HK
dc.subjectHead and neck carcinomaen_HK
dc.subjectRandomized clinical trialen_HK
dc.subjectSquamous cell carcinomaen_HK
dc.subject.meshAgeden_US
dc.subject.meshCarcinoma, Squamous Cell - Drug Therapy - Mortality - Radiotherapyen_US
dc.subject.meshCombined Modality Therapyen_US
dc.subject.meshDisease-Free Survivalen_US
dc.subject.meshFemaleen_US
dc.subject.meshHead And Neck Neoplasms - Drug Therapy - Mortality - Radiotherapyen_US
dc.subject.meshHumansen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNeoplasm Metastasisen_US
dc.subject.meshNeoplasm Stagingen_US
dc.subject.meshNeoplasms, Second Primary - Etiologyen_US
dc.subject.meshPatient Complianceen_US
dc.subject.meshRegression Analysisen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleAlternating chemoradiotherapy versus partly accelerated radiotherapy in locally advanced squamous cell carcinoma of the head and neck: Results from a phase III randomized trialen_HK
dc.typeArticleen_HK
dc.identifier.emailChua, DTT: dttchua@hkucc.hku.hken_HK
dc.identifier.emailWei, WI: hrmswwi@hku.hken_HK
dc.identifier.authorityChua, DTT=rp00415en_HK
dc.identifier.authorityWei, WI=rp00323en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1002/1097-0142(20011201)92:11<2856::AID-CNCR10132>3.0.CO;2-6en_HK
dc.identifier.pmid11753959-
dc.identifier.scopuseid_2-s2.0-0035575766en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035575766&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume92en_HK
dc.identifier.issue11en_HK
dc.identifier.spage2856en_HK
dc.identifier.epage2867en_HK
dc.identifier.isiWOS:000172310400015-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridChua, DTT=7006773480en_HK
dc.identifier.scopusauthoridSham, JST=7101655565en_HK
dc.identifier.scopusauthoridWei, WI=7403321552en_HK
dc.identifier.scopusauthoridHo, WK=7402968844en_HK
dc.identifier.scopusauthoridAu, GKH=7003748615en_HK

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