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

20 Citations (Scopus)

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 2008

Fingerprint

Head and Neck Neoplasms
Radio
Conformal Radiotherapy
Radiotherapy
Radiation
Survival
Xerostomia
Hemoglobins
Neoplasm Metastasis
Therapeutics
Squamous Cell Neoplasms
Neoplasm Grading
Parotid Gland
Multivariate Analysis
Outcome Assessment (Health Care)
Drug Therapy
Neoplasms

Keywords

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

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cancer Research
  • Radiological and Ultrasound Technology

Cite this

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

In: Strahlentherapie und Onkologie, Vol. 184, No. 4, 04.2008, p. 198-205.

Research output: Contribution to journalArticle

Rades, D, Stoehr, M, Meyners, T, Bohlen, G, Nadrowitz, R, Dunst, J, Schild, SE, 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, vol. 184, no. 4, pp. 198-205. https://doi.org/10.1007/s00066-008-1825-3
Rades, Dirk ; Stoehr, Monika ; Meyners, Thekla ; Bohlen, Guenther ; Nadrowitz, Roger ; Dunst, Juergen ; Schild, Steven E. ; Wroblewski, Junes ; Albers, Dirk ; Schmidt, Rainer ; Alberti, Winfried ; Tribius, Silke. / 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. In: Strahlentherapie und Onkologie. 2008 ; Vol. 184, No. 4. pp. 198-205.
@article{5f501d571cc34c48aeeb11df6335d12f,
title = "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",
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.",
keywords = "3-D conformal RT, Conventional RT, Head-and-neck cancer, Treatment outcome",
author = "Dirk Rades and Monika Stoehr and Thekla Meyners and Guenther Bohlen and Roger Nadrowitz and Juergen Dunst and Schild, {Steven E.} and Junes Wroblewski and Dirk Albers and Rainer Schmidt and Winfried Alberti and Silke Tribius",
year = "2008",
month = "4",
doi = "10.1007/s00066-008-1825-3",
language = "English (US)",
volume = "184",
pages = "198--205",
journal = "Strahlentherapie und Onkologie : Organ der Deutschen R{\"o}ntgengesellschaft ... [et al]",
issn = "0179-7158",
publisher = "Urban und Vogel",
number = "4",

}

TY - JOUR

T1 - 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

AU - Rades, Dirk

AU - Stoehr, Monika

AU - Meyners, Thekla

AU - Bohlen, Guenther

AU - Nadrowitz, Roger

AU - Dunst, Juergen

AU - Schild, Steven E.

AU - Wroblewski, Junes

AU - Albers, Dirk

AU - Schmidt, Rainer

AU - Alberti, Winfried

AU - Tribius, Silke

PY - 2008/4

Y1 - 2008/4

N2 - 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.

AB - 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.

KW - 3-D conformal RT

KW - Conventional RT

KW - Head-and-neck cancer

KW - Treatment outcome

UR - http://www.scopus.com/inward/record.url?scp=41949105823&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=41949105823&partnerID=8YFLogxK

U2 - 10.1007/s00066-008-1825-3

DO - 10.1007/s00066-008-1825-3

M3 - Article

C2 - 18398584

AN - SCOPUS:41949105823

VL - 184

SP - 198

EP - 205

JO - Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]

JF - Strahlentherapie und Onkologie : Organ der Deutschen Röntgengesellschaft ... [et al]

SN - 0179-7158

IS - 4

ER -