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IMRT-SIB with concurrent and neo-adjuvant platinum-based chemotherapy for locally advanced head and neck squamous cell cancer: analysis of clinical outcomes in a retrospective series of a single institution

Abstract

Aims and background. To evaluate results of an intensity-modulated radiotherapy with simultaneous integrated boost schedule with concurrent and neo-adjuvant platinum-based chemotherapy for the definitive treatment of locally advanced head and neck cancer in a retrospective series.
Methods and study design. Between May 2007 and February 2010, 28 consecutive patients with locally advanced head and neck cancer (stage II, 11%; III, 18%; IV, 71%) received intensity-modulated radiotherapy with simultaneous integrated boost with concurrent and neoadjuvant (20/28 patients) chemotherapy, at 1.8 G/die to 54 Gy to the elective volume and 66 Gy (2.2 Gy/die) to the tumor volume. Acute and late toxicities were scored according to RTOG/EORTC. A quality of life questionnaire for late xerostomia was also administered. Locoregional control and overall survival were estimated using Kaplan–Meier analysis.
Results. Median follow-up was 50 months, there was no grade 4 acute/late toxicity. Major acute toxicities were grade 2+ mucositis, 79%; grade 2+ xerostomia, 54%; grade 2+ dysphagia, 86%; 54% of patients required parenteral nutrition. The most relevant late reaction was grade 1 xerostomia (64%), which gradually recovered with time. A linear correlation between the RTOG/EORTC scale and the quality of life questionnaire value (P = 0.0120, r2 = 0.2641) was found, receiver operating characteristic analysis (ROC) confirmed sensitivity of the quality of life questionnaire to define grade 2 late salivary toxicity (P = 0.019). Five-year actuarial locoregional control and overall survival were 81% ± 7.7 SE and 82% ± 7.3 SE, respectively.
Conclusions. A prospective trial of the intensity-modulated radiotherapy with simultaneous integrated boost schedule tested in this retrospective series with concurrent and neoadjuvant chemotherapy seems warranted in order to establish this approach as a standard regimen of intensity-modulated radiotherapy with simultaneous integrated boost chemoradiation.

Tumori 2014; 100(6): 652 - 659

Article Type: ORIGINAL RESEARCH ARTICLE

DOI:10.1700/1778.19272

OPEN ACCESS ARTICLE

Authors

Ercole Mazzeo, Paolo Antognoni, Manuela Parmiggiani, Consuelo D’Ambrosio, Giuseppina De Marco, Laura Marra, Giovanni Gottardi, Filippo Bertoni

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Authors

  • Mazzeo, Ercole [PubMed] [Google Scholar]
    Department of Radiation Oncology, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy
  • Antognoni, Paolo [PubMed] [Google Scholar]
    Department of Radiotherapy, Azienda Ospedaliera Universitaria Ospedale di Circolo e Fondazione Macchi, Varese, Italy
  • Parmiggiani, Manuela [PubMed] [Google Scholar]
    Department of Radiation Oncology, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy
  • D’Ambrosio, Consuelo [PubMed] [Google Scholar]
    Department of Oncology and Hematology, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy
  • De Marco, Giuseppina [PubMed] [Google Scholar]
    Department of Radiation Oncology, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy
  • Marra, Laura [PubMed] [Google Scholar]
    Department of Oncology and Hematology, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy
  • Gottardi, Giovanni [PubMed] [Google Scholar]
    Department of Medical Physics, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy
  • Bertoni, Filippo [PubMed] [Google Scholar]
    Department of Radiation Oncology, Azienda Ospedaliero Universitaria Policlinico, Modena, Italy

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