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Predictors of severe late radiotherapy-related toxicity after hyperfractionated radiotherapy with or without concomitant cisplatin in locally advanced head and neck cancer. Secondary retrospective analysis of a randomized phase III trial (SAKK 10/94)


Ghadjar, P; Simcock, M; Zimmermann, F; Betz, M; Bodis, S; Bernier, J; Studer, G; Aebersold, M (2012). Predictors of severe late radiotherapy-related toxicity after hyperfractionated radiotherapy with or without concomitant cisplatin in locally advanced head and neck cancer. Secondary retrospective analysis of a randomized phase III trial (SAKK 10/94). Radiotherapy and Oncology, 104(2):213-218.

Abstract

BACKGROUND AND PURPOSE:
This secondary analysis was performed to identify predictive factors for severe late radiotherapy (RT)-related toxicity after treatment with hyperfractionated RT +/- concomitant cisplatin in locally advanced head and neck cancer.
MATERIALS AND METHODS:
Patients were retrospectively analyzed from the previously reported randomized phase III trial: SAKK 10/94. Severe late RT-related toxicity was defined as late RTOG ⩾ grade 3 toxicity starting 3months after end of RT and/or potential treatment-related death within 3years of randomization.
RESULTS:
Two hundred and thirteen randomized patients were analyzed; 84 (39%) experienced severe late RT-related toxicity. With median follow-up of 9.7years (range, 0.4-15.4years), median time to severe late RT-related toxicity was 9.6years. In the univariate Cox proportional hazards model the following variables were associated with severe late RT-related toxicity: advanced N-classification (p<0.001); technically unresectable disease (p=0.04); weight loss ratio (p=0.003); supportive measures (p=0.009) and severe acute dysphagia (p=0.001). In the subsequent multivariate analysis all variables except use of supportive measures remained statistically significant.
CONCLUSIONS:
Chemotherapy did not appear to affect severe late RT-related toxicity, but advanced N-classification, technically unresectable disease, weight loss ratio, and severe acute dysphagia were independent predictive factors for severe late RT-related toxicity.

Abstract

BACKGROUND AND PURPOSE:
This secondary analysis was performed to identify predictive factors for severe late radiotherapy (RT)-related toxicity after treatment with hyperfractionated RT +/- concomitant cisplatin in locally advanced head and neck cancer.
MATERIALS AND METHODS:
Patients were retrospectively analyzed from the previously reported randomized phase III trial: SAKK 10/94. Severe late RT-related toxicity was defined as late RTOG ⩾ grade 3 toxicity starting 3months after end of RT and/or potential treatment-related death within 3years of randomization.
RESULTS:
Two hundred and thirteen randomized patients were analyzed; 84 (39%) experienced severe late RT-related toxicity. With median follow-up of 9.7years (range, 0.4-15.4years), median time to severe late RT-related toxicity was 9.6years. In the univariate Cox proportional hazards model the following variables were associated with severe late RT-related toxicity: advanced N-classification (p<0.001); technically unresectable disease (p=0.04); weight loss ratio (p=0.003); supportive measures (p=0.009) and severe acute dysphagia (p=0.001). In the subsequent multivariate analysis all variables except use of supportive measures remained statistically significant.
CONCLUSIONS:
Chemotherapy did not appear to affect severe late RT-related toxicity, but advanced N-classification, technically unresectable disease, weight loss ratio, and severe acute dysphagia were independent predictive factors for severe late RT-related toxicity.

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Additional indexing

Item Type:Journal Article, not refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Radiation Oncology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2012
Deposited On:22 Aug 2012 07:12
Last Modified:05 Apr 2016 15:56
Publisher:Elsevier
ISSN:0167-8140
Publisher DOI:https://doi.org/10.1016/j.radonc.2012.05.004
PubMed ID:22726581

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