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

Research output: Contribution to journalConference article in JournalResearchpeer-review

Abstract

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.

Original languageEnglish
JournalActa Oncologica
Volume58
Issue number10
Pages (from-to)1495-1501
Number of pages7
ISSN0284-186X
DOIs
Publication statusPublished - 2019
EventActa Oncologica symposium: BiGART2019 - Biology-Guided Adaptive Radiotherapy - Aarhus, Denmark
Duration: 22 May 201924 May 2019
http://www.bigart2019.dk/

Conference

ConferenceActa Oncologica symposium: BiGART2019 - Biology-Guided Adaptive Radiotherapy
CountryDenmark
CityAarhus
Period22/05/201924/05/2019
Internet address

Fingerprint

Multicenter Studies
Radiotherapy
Oropharynx
Deglutition Disorders
Larynx
Mouth
Nimorazole
Oropharyngeal Neoplasms
Morbidity
Carcinoma, squamous cell of head and neck
Xerostomia
Hypopharynx
Survival
Enteral Nutrition
Pharynx
Therapeutics
Databases
Radiation
Drug Therapy
Incidence

Cite this

Saksø, Mette ; Andersen, Elo ; Bentzen, Jens ; Andersen, Maria ; Johansen, Jorgen ; Primdahl, Hanne ; Overgaard, Jens ; Eriksen, Jesper Grau. / A prospective, multicenter DAHANCA study of hyperfractionated, accelerated radiotherapy for head and neck squamous cell carcinoma. In: Acta Oncologica. 2019 ; Vol. 58, No. 10. pp. 1495-1501.
@inproceedings{caf71d8035064dd58495426cefac169e,
title = "A prospective, multicenter DAHANCA study of hyperfractionated, accelerated radiotherapy for head and neck squamous cell carcinoma.",
abstract = "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.",
author = "Mette Saks{\o} and Elo Andersen and Jens Bentzen and Maria Andersen and Jorgen Johansen and Hanne Primdahl and Jens Overgaard and Eriksen, {Jesper Grau}",
year = "2019",
doi = "10.1080/0284186X.2019.1658897",
language = "English",
volume = "58",
pages = "1495--1501",
journal = "Acta Oncologica",
issn = "0284-186X",
publisher = "Taylor & Francis",
number = "10",

}

A prospective, multicenter DAHANCA study of hyperfractionated, accelerated radiotherapy for head and neck squamous cell carcinoma. / Saksø, Mette; Andersen, Elo; Bentzen, Jens; Andersen, Maria; Johansen, Jorgen; Primdahl, Hanne; Overgaard, Jens; Eriksen, Jesper Grau.

In: Acta Oncologica, Vol. 58, No. 10, 2019, p. 1495-1501.

Research output: Contribution to journalConference article in JournalResearchpeer-review

TY - GEN

T1 - A prospective, multicenter DAHANCA study of hyperfractionated, accelerated radiotherapy for head and neck squamous cell carcinoma.

AU - Saksø, Mette

AU - Andersen, Elo

AU - Bentzen, Jens

AU - Andersen, Maria

AU - Johansen, Jorgen

AU - Primdahl, Hanne

AU - Overgaard, Jens

AU - Eriksen, Jesper Grau

PY - 2019

Y1 - 2019

N2 - 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.

AB - 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.

U2 - 10.1080/0284186X.2019.1658897

DO - 10.1080/0284186X.2019.1658897

M3 - Conference article in Journal

VL - 58

SP - 1495

EP - 1501

JO - Acta Oncologica

JF - Acta Oncologica

SN - 0284-186X

IS - 10

ER -