A prospective, multicenter DAHANCA study of hyperfractionated, accelerated radiotherapy for head and neck squamous cell carcinoma.

Mette Saksø, Elo Andersen, Jens Bentzen, Maria Andersen, Jorgen Johansen, Hanne Primdahl, Jens Overgaard, Jesper Grau Eriksen

Publikation: Bidrag til tidsskriftKonferenceartikel i tidsskriftForskningpeer review

16 Citationer (Scopus)

Abstrakt

Background: The study aimed to evaluate Hyperfractionated, Accelerated Radiotherapy (HART) with nimorazole for patients with head and neck squamous cell carcinoma (HNSCC) using loco-regional failure (LRF), overall survival (OS), early and late morbidity as endpoints. Material and methods: From February 2007 to January 2018, 295 patients with unresected HNSCC, T1-T4, N0-N3, M0, were treated with HART prescribed as 76 Gy in 56 fractions (fx), 10 fx weekly. IMRT was used in >90% of patients. No chemotherapy was given. Patients were prospectively registered in the DAHANCA database. Results: The median age was 64 years, 75% of patients were males. Primary sites were larynx (25%), pharynx (64%) and oral cavity (11%). In total, 59% were stage III-IV (UICC 2002). Of the 150 oropharyngeal cancer (OPC) patients, 42% were p16+. The proportion of patients receiving HART as planned was 97%. The median follow-up time was 66 months. Three-year actuarial LRF was 19% and OS was 66%. LRF was significantly higher for stage III-IV patients compared to stage I-II (25% vs. 11%, HR 2.12 [1.21-3.74]). The site-specific LRF rates were: for larynx 22% [12-32], hypopharynx 30% [16-45], non-p16+ oropharynx 15% [8-23], p16+ oropharynx 7% [1-13] and oral cavity 35% [18-53]. During therapy, 51% reported severe dysphagia and 60% required feeding tubes. The peak incidence of late, severe dysphagia and xerostomia was 21% and 9%, respectively. A comparison to historical data from previous DAHANCA trials showed that tumor control and morbidity are comparable to treatment with acceleration and/or chemo-radiation. Conclusions: HART represents an attractive approach for patients with HNSCC where treatment intensification is indicated.

OriginalsprogEngelsk
TidsskriftActa Oncologica
Vol/bind58
Udgave nummer10
Sider (fra-til)1495-1501
Antal sider7
ISSN0284-186X
DOI
StatusUdgivet - 2019
BegivenhedActa Oncologica symposium: BiGART2019 - Biology-Guided Adaptive Radiotherapy - Aarhus, Danmark
Varighed: 22 maj 201924 maj 2019
http://www.bigart2019.dk/

Konference

KonferenceActa Oncologica symposium: BiGART2019 - Biology-Guided Adaptive Radiotherapy
Land/OmrådeDanmark
ByAarhus
Periode22/05/201924/05/2019
Internetadresse

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