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Feasibility and Efficacy of Accelerated Weekly Concomitant Boost Postoperative Radiation Therapy Combined with Concomitant Chemotherapy in Patients with Locally Advanced Head and Neck Cancer

  • Head and Neck Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Background

The aim of this study was to assess feasibility and efficacy of weekly concomitant boost accelerated postoperative radiation therapy (PORT) with concomitant chemotherapy (CT) in patients with locally advanced head and neck cancer (LAHNC).

Methods and Materials

Conformal or intensity-modulated 66-Gy RT was performed in 5.5 weeks in 40 patients. Cisplatin was given at days 1, 22, and 43. Median follow-up was 36 months.

Results and Discussion

Grade 3 mucositis, dysphagia, and erythema was observed in ten (25%), nine (23%), and six (13%) patients, respectively. Grade 3 or more anemia was observed in two (6%) patients, and leukopenia in five (13%) patients. No grade 3 or 4 thrombocytopenia was observed. Grade 3 nephrotoxicity was observed in one patient (3%). No treatment-related mortality was observed. Grade 2 or more xerostomia and edema were observed in ten (25%) and one (3%) patient, respectively. Locoregional relapse occurred in eight patients, and seven patients developed distant metastases. Median time to locoregional relapse was 6 months. Three-year overall, disease-free survival, and locoregional control rates were 63%, 62%, and 81%, respectively. Multivariate analysis revealed that the only prognostic factor was nodal status.

Conclusion

Reducing overall treatment time using accelerated PORT/CT by weekly concomitant boost (six fractions per week) combined with concomitant cisplatin CT is easily feasible with acceptable morbidity.

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Authors and Affiliations

  1. Department of Radiation Oncology, University Hospital Center, University of Lausanne, Lausanne, Switzerland

    Berrin Pehlivan MD, Oscar Matzinger MD, Michael Betz MD, Daniela Dragusanu MD, Shelley Bulling MSc, René O. Mirimanoff MD, Abderrahim Zouhair MD & Mahmut Ozsahin MD, PhD

  2. Department of Medical Oncology, University Hospital Center, University of Lausanne, Lausanne, Switzerland

    Francois Luthi MD

  3. Department of Otorhinolaryngology, University Hospital Center, University of Lausanne, Lausanne, Switzerland

    Luc Bron MD & Philippe Pasche MD

  4. Department of Pathology, University Hospital Center, University of Lausanne, Lausanne, Switzerland

    Walter Seelentag MD

Authors
  1. Berrin Pehlivan MD
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  2. Francois Luthi MD
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  3. Oscar Matzinger MD
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  4. Michael Betz MD
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  7. Luc Bron MD
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  8. Philippe Pasche MD
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  10. René O. Mirimanoff MD
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  11. Abderrahim Zouhair MD
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  12. Mahmut Ozsahin MD, PhD
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Corresponding author

Correspondence to Mahmut Ozsahin MD, PhD.

Additional information

Abderrahim Zouhair and Mahmut Ozsahin contributed equally as senior author.

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Pehlivan, B., Luthi, F., Matzinger, O. et al. Feasibility and Efficacy of Accelerated Weekly Concomitant Boost Postoperative Radiation Therapy Combined with Concomitant Chemotherapy in Patients with Locally Advanced Head and Neck Cancer. Ann Surg Oncol 16, 1337–1343 (2009). https://doi.org/10.1245/s10434-009-0426-4

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  • DOI: https://doi.org/10.1245/s10434-009-0426-4

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