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Surgery and adjuvant radiotherapy vs concurrent chemoradiotherapy in stage III/IV nonmetastatic squamous cell head and neck cancer: a randomised comparison.

Soo KC, Tan EH, Wee J, Lim D, Tai BC, Khoo ML, Goh C, Leong SS, Tan T, Fong KW, Lu P, See A, Machin D - Br. J. Cancer (2005)

Bottom Line: A total of 119 patients were randomised.Those with laryngeal/hypopharyngeal disease subsite had a higher organ-preservation rate than the rest (68 vs 30%).However, this form of treatment schedule with a view to organ-preservation can be attempted especially for those with laryngeal/hypopharyngeal and possibly oropharyngeal disease subsites.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, National Cancer Centre, Singapore. admskc@nccs.com.sg

ABSTRACT
We compared concurrent combination chemotherapy and radiotherapy with surgery and adjuvant radiotherapy in patients with stage III/IV nonmetastatic squamous cell head and neck cancer. Patients with non-nasopharyngeal and nonsalivary resectable squamous cell head and neck cancer were randomised to receive either surgery followed by adjuvant radiotherapy (60 Gy over 30 fractions) or concurrent combination chemotherapy and radiotherapy (66 Gy in 33 fractions). Combination chemotherapy comprised two cycles of i.v. cisplatin 20 mg m(-2) day(-1) and i.v. 5-fluorouracil 1000 mg m(-2) day(-1), both to run over 96 h given on days 1 and 28 of the radiotherapy. A total of 119 patients were randomised. At a median follow-up of 6 years, there was no significant difference in the 3-year disease-free survival rate between the surgery and concurrent chemoradiotherapy (50 vs 40% respectively). The overall organ preservation rate or avoidance of surgery to primary site was 45%. Those with laryngeal/hypopharyngeal disease subsite had a higher organ-preservation rate than the rest (68 vs 30%). Combination chemotherapy and concurrent irradiation with salvage surgery was not superior to conventional surgery and postoperative radiotherapy for resectable advanced squamous cell head and neck cancer. However, this form of treatment schedule with a view to organ-preservation can be attempted especially for those with laryngeal/hypopharyngeal and possibly oropharyngeal disease subsites.

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Related in: MedlinePlus

Disease-free survival by treatment. Three patients in S relapsed before completion of radiotherapy. The date of surgery was thus taken as the date of treatment completion. Another patient who died within a week of completion of salvage surgery was considered disease-free.
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fig3: Disease-free survival by treatment. Three patients in S relapsed before completion of radiotherapy. The date of surgery was thus taken as the date of treatment completion. Another patient who died within a week of completion of salvage surgery was considered disease-free.

Mentions: The Kaplan–Meier DFS curves for the two treatment groups are shown in Figure 3. The median disease-free survival time was 1.6 years for arm C and was not reached for arm S. The 3-year DFS rates for the two groups were 43% for C and 54% for S. This difference was not statistically significant.


Surgery and adjuvant radiotherapy vs concurrent chemoradiotherapy in stage III/IV nonmetastatic squamous cell head and neck cancer: a randomised comparison.

Soo KC, Tan EH, Wee J, Lim D, Tai BC, Khoo ML, Goh C, Leong SS, Tan T, Fong KW, Lu P, See A, Machin D - Br. J. Cancer (2005)

Disease-free survival by treatment. Three patients in S relapsed before completion of radiotherapy. The date of surgery was thus taken as the date of treatment completion. Another patient who died within a week of completion of salvage surgery was considered disease-free.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2361563&req=5

fig3: Disease-free survival by treatment. Three patients in S relapsed before completion of radiotherapy. The date of surgery was thus taken as the date of treatment completion. Another patient who died within a week of completion of salvage surgery was considered disease-free.
Mentions: The Kaplan–Meier DFS curves for the two treatment groups are shown in Figure 3. The median disease-free survival time was 1.6 years for arm C and was not reached for arm S. The 3-year DFS rates for the two groups were 43% for C and 54% for S. This difference was not statistically significant.

Bottom Line: A total of 119 patients were randomised.Those with laryngeal/hypopharyngeal disease subsite had a higher organ-preservation rate than the rest (68 vs 30%).However, this form of treatment schedule with a view to organ-preservation can be attempted especially for those with laryngeal/hypopharyngeal and possibly oropharyngeal disease subsites.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgical Oncology, National Cancer Centre, Singapore. admskc@nccs.com.sg

ABSTRACT
We compared concurrent combination chemotherapy and radiotherapy with surgery and adjuvant radiotherapy in patients with stage III/IV nonmetastatic squamous cell head and neck cancer. Patients with non-nasopharyngeal and nonsalivary resectable squamous cell head and neck cancer were randomised to receive either surgery followed by adjuvant radiotherapy (60 Gy over 30 fractions) or concurrent combination chemotherapy and radiotherapy (66 Gy in 33 fractions). Combination chemotherapy comprised two cycles of i.v. cisplatin 20 mg m(-2) day(-1) and i.v. 5-fluorouracil 1000 mg m(-2) day(-1), both to run over 96 h given on days 1 and 28 of the radiotherapy. A total of 119 patients were randomised. At a median follow-up of 6 years, there was no significant difference in the 3-year disease-free survival rate between the surgery and concurrent chemoradiotherapy (50 vs 40% respectively). The overall organ preservation rate or avoidance of surgery to primary site was 45%. Those with laryngeal/hypopharyngeal disease subsite had a higher organ-preservation rate than the rest (68 vs 30%). Combination chemotherapy and concurrent irradiation with salvage surgery was not superior to conventional surgery and postoperative radiotherapy for resectable advanced squamous cell head and neck cancer. However, this form of treatment schedule with a view to organ-preservation can be attempted especially for those with laryngeal/hypopharyngeal and possibly oropharyngeal disease subsites.

Show MeSH
Related in: MedlinePlus