Evaluation of prognostic factors and two radiation techniques in patients treated with surgery followed by radio(chemo)therapy or definitive radio(chemo)therapy for locally advanced head-and-neck cancer

Dirk Rades, Monika Stoehr, Thekla Meyners, Guenther Bohlen, Roger Nadrowitz, Juergen Dunst, Steven E. Schild, Junes Wroblewski, Dirk Albers, Rainer Schmidt, Winfried Alberti, Silke Tribius

Research output: Contribution to journalArticle

22 Scopus citations

Abstract

Background and Purpose: Conventional radiotherapy (RT) still is the standard technique for head-and-neck cancer in many centers worldwide, whereas other centers replaced this technique by 3-D conformal RT, which is associated with more appropriate dose distributions. Comparative studies regarding outcome and toxicity are lacking. This study compared both techniques for overall survival (OS), metastases-free survival (MFS), loco-regional control (LC), and toxicity in stage III/IV head-and-neck cancer. Patients and Methods: Data of 345 patients irradiated for stage III/IV squamous cell head-and-neck cancer were retrospectively analyzed. Patients received conventional RT (group A, n = 166) or 3-D conformal RT (group B, n = 179). Both techniques were compared for outcomes and toxicity. Eleven further potential prognostic factors were investigated: age, gender, performance status, tumor site, grading, T-stage, N-stage, AJCC-stage, chemotherapy, surgery, pre-RT hemoglobin. Results: 3-year-OS was 62% in group A and 57% in group B (p = 0.15). 3-year-MFS was 67% and 76% (p = 0.46), 3-year-LC was 65% and 68%, respectively (p = 0.71). On multivariate analysis, gender (p = 0.005), performance status (p < 0.001), T-stage (p = 0.002), and N-stage (p < 0.001) were associated with OS. MFS was influenced by performance status (p < 0.001) and N-stage (p < 0.001), LC by gender (p = 0.021), T-stage (p < 0.001), and pre-RT hemoglobin level (≥ 12 better than < 12 g/dl, p = 0.004). Grade 2-3 xerostomia was less frequent with 3-D conformal RT (43% vs. 58%, p = 0.06). Otherwise, toxicities were similar. Conclusion: Both RT techniques resulted in similar treatment outcomes. Because xerostomia was less with 3-D conformal RT, this technique appeared beneficial for patients, in whom one parotid gland can be spared. Outcome was associated with gender, performance status, tumor stage, and pre-RT hemoglobin.

Original languageEnglish (US)
Pages (from-to)198-205
Number of pages8
JournalStrahlentherapie und Onkologie
Volume184
Issue number4
DOIs
StatePublished - Apr 1 2008

Keywords

  • 3-D conformal RT
  • Conventional RT
  • Head-and-neck cancer
  • Treatment outcome

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Oncology

Fingerprint Dive into the research topics of 'Evaluation of prognostic factors and two radiation techniques in patients treated with surgery followed by radio(chemo)therapy or definitive radio(chemo)therapy for locally advanced head-and-neck cancer'. Together they form a unique fingerprint.

  • Cite this

    Rades, D., Stoehr, M., Meyners, T., Bohlen, G., Nadrowitz, R., Dunst, J., Schild, S. E., Wroblewski, J., Albers, D., Schmidt, R., Alberti, W., & Tribius, S. (2008). Evaluation of prognostic factors and two radiation techniques in patients treated with surgery followed by radio(chemo)therapy or definitive radio(chemo)therapy for locally advanced head-and-neck cancer. Strahlentherapie und Onkologie, 184(4), 198-205. https://doi.org/10.1007/s00066-008-1825-3