Importance of comorbidity in hypopharyngeal cancer

Homma, Akihiro; Sakashita, Tetsuya; Suzuki, Fumiyuki; Suzuki, Seigo; Hatakeyama, Hyōe; Mizumachi, Takatsugu; Taki, Shigenari; Fukuda, Satoshi

doi:10.1002/hed.21158

Cited by 27 publications

(27 citation statements)

References 16 publications

(18 reference statements)

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“…Therefore, we have used weekly cisplatin regimen at a dose of 40mg/m 2 at our institution since 2006. In our previous study, it was revealed that the application of concomitant weekly cisplatin chemotherapy and radiotherapy was safety and feasible [5]. In the current study, the nodal control rate for patients treated weekly cisplatin chemoradiotherapy was high.…”

Section: Discussionmentioning

confidence: 57%

“…Therefore, weekly cisplatin at a dose of 40mg/m 2 has been used at our institution since 2006. We reported that weekly cisplatin was easier to manage than three-weekly cisplatin, because patients could be monitored more regularly for toxicity, thereby allowing the schedule to be altered if required [5]. This retrospective study was aimed at assessing the oncologic efficacy of concomitant weekly cisplatin chemoradiotherapy without planned neck dissection (ND) for the control of neck disease.…”

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confidence: 99%

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Regional control after concomitant chemoradiotherapy without planned neck dissection in node-positive head and neck squamous cell carcinomas

et al. 2013

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dissection in node-positive head and neck squamous cell carcinomas. AbstractObjectives: Although three-weekly high-dose (100mg/m 2 ) cisplatin (three cycles) chemoradiotherapy has been considered a standard regimen for patients with advanced head and neck squamous cell carcinomas (HNSCC), this protocol is associated with significant acute and late toxicities. Therefore, weekly cisplatin at a dose of 40mg/m 2 has been used at our institution since 2006. This retrospective study was aimed at assessing the oncologic efficacy of weekly cisplatin chemoradiotherapy for the control of nodal metastasis.Methods: We analyzed 28 patients with node-positive HNSCC treated with weekly cisplatin and concurrent radiotherapy. Computed tomography was performed 4-8 weeks after the completion of chemoradiotherapy to evaluate nodal response. If residual neck disease was apparent or suspected, we performed early salvage neck dissection (ND). In cases with a complete response (CR), we took a " wait and see " approach.When no viable tumor cells were observed in the surgical specimens obtained by ND, nodal metastasis was defined as controlled by weekly cisplatin chemoradiotherapy alone.Results: Nodal metastasis was evaluated as having a CR in 20 patients (71%). Eight patients (29%) underwent early salvage ND. Recurrent primary tumors were observed in the other four patients (14%). Salvage primary resection and associated ND were performed for these four patients.In 7 of 12 patients undergoing ND, no viable tumor cells were observed. In 23 of 28 patients, neck diseases were controlled by chemoradiotherapy alone (not including salvage by ND). In 27 of 28 patients, neck diseases were controlled by the overall treatment (including salvage by ND). The rate of nodal control by chemoradiotherapy alone and by the overall treatment was found to be 82.0% and 96.3%, respectively, using the Kaplan-Meier method.The three-year overall and disease free survival rates were 86.8% and 80.8%, Although three-weekly high-dose (100mg/m 2 ) cisplatin (three cycles) and radiotherapy has been considered a standard regimen for patients with advanced HNSCC, this protocol is associated with significant acute and late toxicities [1][2][3][4]. Furthermore, the completion rate for this regimen is relatively poor [1][2]. Therefore, weekly cisplatin at a dose of 40mg/m 2 has been used at our institution since 2006. We reported that weekly cisplatin was easier to manage than three-weekly cisplatin, because patients could be monitored more regularly for toxicity, thereby allowing the schedule to be altered if required [5]. This retrospective study was aimed at assessing the oncologic efficacy of concomitant weekly cisplatin chemoradiotherapy without planned neck dissection (ND) for the control of neck disease. MATERIAL AND METHODSPatients. Between July 2006 and May 2011, 59 patients with biopsy-proven HNSCC were treated with concurrent weekly cisplatin chemoradiotherapy. Twenty-two patients with N0, seven patients who underwent neo-adjuvant chemotherapy (using cisplatin,...

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confidence: 57%

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confidence: 99%

Regional control after concomitant chemoradiotherapy without planned neck dissection in node-positive head and neck squamous cell carcinomas

et al. 2013

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“…Previous studies reported the incidence of comorbidity in head and neck cancer to be 33-65%, with cardiovascular and pulmonary diseases being the most common [7,[21][22][23][24][25]. Ramakrishnan et al reported an incidence of comorbidity of 44% in 59 patients with NPC, with 19% patients having moderate or severe comorbidity and the cardiovascular system (27%) most commonly affected [9].…”

Section: Prevalence Type and Severity Of Comorbiditymentioning

confidence: 98%

Comorbidity predicts poor prognosis in nasopharyngeal carcinoma: Development and validation of a predictive score model

Guo

Chen

et al. 2015

Radiotherapy and Oncology

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“…However, this intensive chemoradiotherapy is associated with significant acute and late toxicity [1][2][3][4]. In our institution, weekly cisplatin regimen (40mg/m 2 ) has been used for chemoradiotherapy since 2006 [5,6]. The feasibility of this regimen has been examined by Japan Clinical…”

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confidence: 99%

Comparison of acute toxicities associated with cetuximab-based bioradiotherapy and platinum-based chemoradiotherapy for head and neck squamous cell carcinomas: A single-institution retrospective study in Japan

Sakashita¹,

Homma²,

Hatakeyama³

et al. 2015

Acta Oto-Laryngologica

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ABSTARACTConclusion. Grade≧3 mucositis/stomatitis and inability to feed orally were problematic for patients undergoing cetuximab-based bioradiotherapy (BRT) as well as platinum-based chemoradiotherapy (CRT). Severe mucositis/stomatitis and radiation dermatitis should be addressed carefully in patients undergoing cetuximab-based BRT as well.Objectives. The efficacy of cetuximab-based BRT in locally advanced head and neck squamous cell carcinomas has been established. However, the safety of cetuximab-based BRT in comparison with platinum-based CRT is currently under investigation.Method. We retrospectively analyzed 14 patients undergoing cetuximab-based BRT and 29 patients undergoing platinum-based CRT to compare the incidence of acute toxicities.In BRT group, an initial cetuximab loading dose of 400 mg/m 2 was delivered one week before the start of radiotherapy. Seven weekly infusions of 250 mg/m 2 of cetuximab followed during the definitive radiotherapy. In CRT group, cisplatin was administered at a dose of 40mg/m 2 weekly during the definitive radiotherapy.Results. The BRT group had a higher incidence of Grade≧3 radiation dermatitis than did the CRT group (36% vs 3%, respectively, p<0.01). The incidence rate of Grade≧3 mucositis/stomatitis was 64.3 % and 41.4% in the BRT and CRT group, respectively (p=0.1484), while the incidence rate of the inability to feed orally was 38.5% and 55.2%, respectively (p=0.2053).

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Importance of comorbidity in hypopharyngeal cancer

Abstract: Comorbidity, along with the clinical stage, should be considered in treatment planning for patients with HPC.

Cited by 27 publications

References 16 publications

Regional control after concomitant chemoradiotherapy without planned neck dissection in node-positive head and neck squamous cell carcinomas

Regional control after concomitant chemoradiotherapy without planned neck dissection in node-positive head and neck squamous cell carcinomas

Comorbidity predicts poor prognosis in nasopharyngeal carcinoma: Development and validation of a predictive score model

Comparison of acute toxicities associated with cetuximab-based bioradiotherapy and platinum-based chemoradiotherapy for head and neck squamous cell carcinomas: A single-institution retrospective study in Japan

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