Quantification of the effect of treatment duration on local‐regional failure after definitive concurrent chemotherapy and intensity‐modulated radiation therapy for squamous cell carcinoma of the head and neck

Platek, Mary E.; McCloskey, Susan A.; Cruz, M.; Burke, Mark S.; Reid, Mary E.; Wilding, Gregory E.; Rigual, Néstor R.; Popat, Saurin R.; Loree, Thom R.; Gupta, Vishal; Warren, Graham; Sullivan, Maureen; Hicks, Wesley L.; Singh, Anurag K.

doi:10.1002/hed.23024

Cited by 45 publications

(54 citation statements)

References 26 publications

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“…Based on such data, some may postulate that a benefit of smoking cessation may be related to the additive toxicity of smoking and chemoradiotherapy, which may lead to reduced compliance with therapy or follow‐up. However, we could not draw any conclusions about toxicity, as all but one patient in this series completed CCRT in 47 days or less . Additionally, there was excellent compliance with follow‐up in this cohort regardless of smoking status.…”

Section: Discussionmentioning

confidence: 80%

“…Clinical information regarding the current cancer such as stage, grade, anatomical subsite, treatment modality, cancer recurrence, survival status, survival duration, and cause of death were also collected. The follow‐up patient schedule and the cisplatin‐based chemotherapy (weekly or every 3 weeks) and intensity‐modulated radiation therapy regimens (70 Gy to the primary tumor and 56 Gy to the elective lymph nodes in 35 fractions) applied in this cohort have been previously described in detail …”

Section: Methodsmentioning

confidence: 99%

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Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation

et al. 2016

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Objectives The effect of smoking and human papilloma virus (HPV) on overall survival (OS) of oropharyngeal squamous cell carcinoma (OPSCC) patients undergoing concurrent chemoradiation (CCRT) remains unclear. Study Design Retrospective Review Methods Clinical characteristics of OPSCC patients treated between 2008– 2015 with CCRT were abstracted from medical records. OS curves and multivariate cox proportional hazard ratios (HR) were examined. Results Out of 120 evaluable patients, 71% had HPV+ tumors. Median follow-up duration for the entire cohort was 41.5 months (6–88 months). HPV+ current smokers experienced significantly worse 5 year OS (73% alive vs. 36% alive, p=0.01) with a similar trend in HPV− current smokers (66% alive vs. 31% alive, p=0.28) compared to former/never smokers undergoing CCRT. In a multivariate cox proportional hazard model adjusted for age, gender, and overall tumor stage, HPV+ current smokers experienced nearly a four-fold increase in overall mortality in comparison to HPV+ never/former smokers (HR= 3.68, 95% CI=1.35–10.0). Similarly, current smokers with HPV− tumors (HR= 6.8, 95% CI=1.11–41.67) had increased mortality compared to never/former smokers. Conclusions Current smoking is associated with poor prognosis, independent of HPV status, in OPSCC CCRT treated patients. Current smoking produced an approximately 4 to 7 fold increase in risk of mortality for HPV+ and HPV− patients respectively. Regardless of pack-years, efforts should be made to achieve smoking cessation before CCRT regardless of HPV status.

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Section: Discussionmentioning

confidence: 80%

Section: Methodsmentioning

confidence: 99%

Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation

et al. 2016

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“…Patients in cohort 2 received interventions to prevent treatment interruption resulting in a median decrease in treatment duration of 5 days [30]. As a consequence, these patients may have sustained increased acute effects of treatment, but no significant difference on total weight loss during treatment was observed between the cohorts.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment weight status and weight loss among head and neck cancer patients receiving definitive concurrent chemoradiation therapy: implications for nutrition integrated treatment pathways

Platek

Myrick

McCloskey

et al. 2013

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Purpose The purpose was to examine the effect of pretreatment weight status on loco-regional progression for patients with squamous cell carcinoma of the head and neck (SCCHN) after receiving definitive concurrent chemoradiation therapy (CCRT). Methods In an expanded cohort of 140 patients, we retrospectively reviewed weight status and loco-regional progression of SCCHN patients treated with CCRT between 2004 and 2010. Results Pretreatment ideal body weight percentage (IBW%) was statistically significantly different for patients with disease progression than for those without progression (p=0.02) but was not an independent predictor of progression. Median pretreatment IBW% was 118 (72–193) for the progression-free group and was 101.5 (73–163) for the group with progression. Both groups suffered clinically severe weight loss of approximately 9 % from baseline to end treatment. Conclusions Pretreatment weight status, a very crude indicator of nutrition status, may have prognostic value in patients with SCCHN undergoing definitive CCRT. Inadequate nutritional status in these patients has been associated with poor clinical outcomes and decreased quality of life. Based on this report and others, the best next steps include routine validated malnutrition screening and the testing of evidence-based nutrition care protocols with the goals of minimizing weight loss and improvement of quality of life.

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“…A strong body of evidence shows that prolonged radiation treatment is associated with worse locoregional control and survival in HNSCC [12][13][14][15] ; however, impact of other treatment time intervals is less conclusive. [16][17][18] According to the National Comprehensive Cancer Network guidelines, the preferred interval between resection and commencement of postoperative radiotherapy (RT) is 6 weeks or less.…”

Section: Introductionmentioning

confidence: 99%

Treatment delays in oral cavity squamous cell carcinoma and association with survival

et al. 2017

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Quantification of the effect of treatment duration on local‐regional failure after definitive concurrent chemotherapy and intensity‐modulated radiation therapy for squamous cell carcinoma of the head and neck

Cited by 45 publications

References 26 publications

Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation

Smoking cessation is associated with improved survival in oropharynx cancer treated by chemoradiation

Pretreatment weight status and weight loss among head and neck cancer patients receiving definitive concurrent chemoradiation therapy: implications for nutrition integrated treatment pathways

Treatment delays in oral cavity squamous cell carcinoma and association with survival

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