Physical examination during chemoradiation predicts outcome of locally advanced head and neck cancer. Secondary results of a randomized phase III trial (SAKK 10/94)

Ghadjar, Pirus; Sun, Hong; Zimmermann, Frank; Bodis, Stephan; Bernier, Jacques; Studer, Gabriela; Aebersold, Daniel M.; the Swiss Group for Clinical Cancer Research (SAKK), on behalf of (2013). Physical examination during chemoradiation predicts outcome of locally advanced head and neck cancer. Secondary results of a randomized phase III trial (SAKK 10/94). Oral oncology, 49(10), pp. 1006-1009. Amsterdam: Elsevier 10.1016/j.oraloncology.2013.07.002

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OBJECTIVES

To analyze the prognostic value of clinical tumor response during chemoradiation for locally advanced head and neck cancer.

PATIENTS AND METHODS

The locoregional response at 50.4Gy was assessed by physical examination (PE) in patients treated within the randomized trial SAKK 10/94 using hyperfractionated radiotherapy (RT), median total dose 74.4Gy with or without cisplatin 20mg/m(2) chemotherapy on 5 consecutive days during weeks 1 and 5 or 6 of RT. Response was classified as a complete response (CR), complete response with uncertainty (Cru), partial response (PR), stable disease (SD), or progressive disease (PD). The primary endpoint was time to treatment failure (TTF) due to any cause. Secondary endpoints included locoregional-recurrence-free survival (LRRFS), distant metastasis-free survival (DMFS) and overall survival (OS). Univariate and multivariate Cox proportional hazards (PH) models were applied to analyze the associations between survival endpoints and clinical tumor response.

RESULTS

A total of 136, 131 and 97 patients were evaluable for response at the primary tumor, lymph nodes and both sites combined, respectively. At 50.4Gy 57/136 (42%), 46/131 (35%) and 21/97 (22%) patients had a good response (CR/Cru vs. PR/SD) at the primary tumor, the lymph nodes, and both sites combined, respectively. The median follow-up times were 11.4, 9.6 and 11.4years for the three groups. Good responses were all significantly associated with improved TTF, LRRFS, DMFS and OS in univariate analysis whereas good response at the primary tumor and lymph nodes remained significantly associated with TTF and OS after multivariate Cox PH models.

CONCLUSIONS

Locoregional response at 50.4Gy was identified as predictor of oncologic outcome. PE during treatment should not be underestimated in clinical practice.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Radiation Oncology
UniBE Contributor:	Ghadjar, Pirus, Aebersold, Daniel Matthias
Subjects:	600 Technology > 610 Medicine & health
ISSN:	1368-8375
Publisher:	Elsevier
Language:	English
Submitter:	Beatrice Scheidegger
Date Deposited:	17 Apr 2014 08:52
Last Modified:	02 Mar 2023 23:23
Publisher DOI:	10.1016/j.oraloncology.2013.07.002
PubMed ID:	23916716
Uncontrolled Keywords:	Chemoradiation, Head and neck cancer, Outcome, Physical examination, Radiotherapy
URI:	https://boris.unibe.ch/id/eprint/38928