Phse Ⅲ study of preoperative concurrent chemoradiotherapy compared with preoperative radiotherapy alone in the treatment of locally advanced head and neck squamons cell carcinona
10.3760/cma.j.issn.1004-4221.2011.05.001
- VernacularTitle:术前同期放化与单纯放疗局部晚期头颈部鳞癌的Ⅲ期临床研究
- Author:
Junlin YI
;
Li GAO
;
Zhengang XU
;
Xiaodong HUANG
;
Shaoyan LIU
;
Jingwei LUO
;
Xiaolei WANG
;
Suyan LI
;
Jianping XIAO
;
Shiping ZHANG
;
Kai WANG
;
Yuan QU
;
Guozhen XU
- Publication Type:Journal Article
- Keywords:
Head and neck squamous cell carcinoma,locally advanced;
Radiotherapy,preoperative;
Concurrent chemoradiotherapy,preoperative;
Surgery;
Prognosis
- From:
Chinese Journal of Radiation Oncology
2011;20(5):363-367
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the role of chemoradiotherapy in the preoperative radiotherapy for locally advanced head and neck squamous cell carcinoma. MethodsFrom Sep. 2002 to Dec. 2008,totally 157 locally advanced head and neck squamous cell carcinoma (HNSCC) patients was assigned to preoperative concurrent chemoradiotherapy group ( n =81 ) or preoperative radiotherapy alone group ( n =76 ) randomly. The chemotherapy regimen was consisted of cisplatin 30 mg/m2, weekly. The radiotherapy in both groups was identical. The primary lesion will continue concurrent chemoradiotherapy or radiotherapy for those the tumor response was or nearly complete remission (CR) and those who refused surgery when evaluated at DT50 Gy, the others will receive surgery 1 month later if the tumor response was less than CR.For N3 patients, the planed neck dissection will be done. ResultsThe follow up rate was 98. 1％, 91patients followed up more than 5 years, there were 46 in concurrent chemoradiotherapy group and 45 in radiotherapy alone group. The rate of 5-year local control, overall survival, disease free survival and distant metastasis-free survival for preoperative concurrent chemoradiotherapy group and preoperative radiotherapy alone group were 63％ and 50％ ( x2 =0. 40,P =0. 528), 46％ and 38％ ( x2 =0. 48,P =0. 490) ,41％ and 35 ( x2 =0. 29, P =0. 593 ) ,76％ and 65％ ( x2 =3.38, P =0. 066 ) respectively. Subgroup analysis showed that the 2-years distant metastasis-free survival of preoperative concurrent chemoradiotherapy group and preoperative radiotherapy alone group were 88％ and 60％ ( x2 =5.99,P =0. 014). ConclusionsPreoper -ative concurrent chemoraidotherapy with the regimen of cisplatin 30 mg/m2 weekly did not improve the overall survival for locally advanced HNSCCwhen compared with preoperative radiotherapy alone.Preoperative concurrent chemoradiotherapy improved the distant metastasis-free survival of locally advanced hypopharyngeal and laryngeal carcinoma.
