Radiation Treatment Interruptions Greater Than One Week and Low Hemoglobin Levels (12 g/dL) are Predictors of Local Regional Failure After Definitive Concurrent Chemotherapy and Intensity-Modulated Radiation Therapy for Squamous Cell Carcinoma of the Head and Neck

McCloskey, Susan A.; Jaggernauth, Wainwright; Rigual, Néstor R.; Hicks, Wesley L.; Popat, Saurin R.; Sullivan, Maureen; Mashtare, Terry; Khan, Mohamed K.; Loree, Thom R.; Singh, Anurag K.

doi:10.1097/coc.0b013e3181967dd0

Cited by 57 publications

(58 citation statements)

References 29 publications

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“…[32] McCloskey et al demonstrated that one week deferral of RT in 78 patients with head and neck cancers was an independent prognostic factor for local control. [15] However, in the present study postponement of RT for 5 days or longer was an independent prognostic factor for 3-year overall survival. This factor was not effective on local control, and disease-free survival.…”

Section: Journal Of Medical Updatescontrasting

confidence: 45%

“…[14] McCloskey et al reported that relatively lower pretreatment hemoglobin level (<12 g/dL) in 78 head and neck cancer patients under definitive CRT is an independent prognostic factor for local disease control. [15] In our study hemoglobin levels below 12 g/dL effected 3-year overall, and disease-free survival rates without any impact on local disease control rates. At the same time, lower hemoglobin values had an independent prognostic effect on overall and disease-free survival.…”

Section: Journal Of Medical Updatesmentioning

confidence: 85%

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Prognosis in head and neck cancer: the importance of the patient-, and treatment-related factors

Yücel¹

2013

J Med Updates

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ÖzetAmaç: Bu çal›flman›n amac› bafl boyun kanserinde prognostik faktör olarak komorbidite, performans durumu, hemoglobin düzeyi, kilo kayb›, radyoterapiye ara verme ve mukozitin öneminin araflt›r›lmas›d›r.Yöntem: Üniversitesimizin Onkoloji Merkezine 2006 ve 2012 tarihleri aras›nda, bafl boyun kanseri tan›s› ile tedavi edilen 210 hastan›n verileri incelendi. Hastalar›n performans durumu, hasta baflvurusunda Eastern Cooperative Oncology Group (ECOG) skorlama sistemine göre de¤erlendirildi. Hastal›k evresi 2010'da revize edilen TNM evrelemesine göre yap›ld›. Bulgular: Hastalar, medyan 24 (da¤›l›m: 1-134) ay takip edildi. Medyan 11 (da¤›l›m: 3-96) ayda hastalar›n %24'ünde nüks geliflirken, medyan 15 (da¤›l›m: 1-134) ayda %13'ünde uzak metastaz geliflti. Tüm hastalar için 3 y›ll›k lokal kontrol %72, 3 y›ll›k genel sa¤-kal›m %59, 3 y›ll›k hastal›ks›z sa¤kal›m %53 idi. Tek de¤iflkenli analizde hastalar›n lokal kontrol oranlar›n› performans durumu (p=0.006), kilo kayb› (p=0.002), hastal›k lokalizasyonu (p=0.003), evre (p<0.001) ve perinöral invazyonun (p=0.011) etkiledi¤i görüldü. Hastalar›n 3 y›ll›k genel sa¤kal›m›n› komorbidite (p=0.045), performans durumu (p<0.001), hemoglobin düzeyi (p<0.001), kilo kayb› (p<0.001), perinöral invazyon (p=0.017), lenfovasküler invazyon (p=0.022), hastal›k lokalizasyonu (p=0.007), evre (p¬<0.001), radyoterapiye ara vermek (p=0.041) etkilemekteydi. Komorbidite (p=0.045), hemoglobin düzeyi (p<0.001), kilo kayb› (p<0.001), perinöral invazyon (p=0.017), lenfovasküler invazyon (p=0.022), hastal›k lokalizasyonu (p=0.007), evre (p<0.001) ise 3 y›ll›k hastal›ks›z sa¤ka-l›m› için prognostik faktörler oldu.Sonuç: Çok de¤iflkenli analizde, kilo kayb› ve perinöral invazyon lokal kontrol için; performans durumu, kilo kayb›, hemoglobin düzeyi ve radyoterapiye ara vermek genel sa¤kal›m için; performans durumu, kilo kayb›, hemoglobin düzeyi hastal›ks›z sa¤kal›m için ba¤›ms›z prognostik faktörler olarak belirlendi.Anahtar sözcükler: Bafl boyun kanseri, kilo kayb›, hemoglobin. AbstractObjective: To investigate the importance of comorbidity, performance status, hemoglobin level, weight loss, interruption of radiotherapy, and mucositis as prognostic factors in head and neck cancer patients.Methods: Two-hundred and ten patients who were admitted to the Oncology Center of our university between 2006 and 2012, and treated for head and neck cancer were included in the study. Performance status at admission was evaluated according to Eastern Cooperative Oncology Group (ECOG) scoring system. Staging of the disease was based on TNM staging system revised in 2010. Results:The median follow-up period was 24 (range: 1-134) months. Recurrence was observed in 24% of the patients in a median 11 (range: 3-96) months. Metastasis was observed in 13% of patients, in the median 15 (range: 1-134 months). The 3-year local control, overall survival and disease-free survival rates were 72%, 59%, and 53%, respectively for all patients. The factors affecting the 3-year local control rates in univariate analysis were performance ...

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Section: Journal Of Medical Updatescontrasting

confidence: 45%

Section: Journal Of Medical Updatesmentioning

confidence: 85%

Prognosis in head and neck cancer: the importance of the patient-, and treatment-related factors

Yücel¹

2013

J Med Updates

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“…However, most patients who are treated with CRT for advanced head and neck cancer suffer from its side effects such as dysphagia, mucositis, xerostomia and nausea. Severe oropharyngeal mucositis leads to decreased oral food intake, resulting in interruption of CRT that may reduce its efficacy (1,2). Nasogastoric tube (NGT) is often placed as enteral nutritional support for head and neck cancer patients with CRT-induced mucositis.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of percutaneous endoscopic gastrostomy on unplanned treatment interruption and nutritional status in patients undergoing chemoradiotherapy for advanced head and neck cancer

et al. 2015

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:Objective : Efficacy of percutaneous endoscopic gastrostomy (PEG) on unplanned treatment interruption and nutritional status was examined in patients undergoing chemoradiotherapy (CRT) for advanced head and neck cancer. Methods : We retrospectively reviewed hospital charts of 44 patients with advanced head and neck cancer who were treated with CRT. Results : CRT-induced mucositis of grade 3 or worse and inadequate oral intake of less than one third of their usual intake developed in 33 patients who were recommended PEG placement, but not in 11 patients. Thirteen patients accepted PEG placement and then completed CRT (compliant group). However, among 20 patients who refused both PEG and nasogastoric tube (NGT) placements (non-compliant group), 10 required unplanned interruptions of CRT at a radiation dose around 30-40 Gy (UI-CRT group) while 10 others could complete CRT without interruption (C-CRT group) CRT. Total serum protein levels were significantly decreased after CRT in all patients. Discussion : It is suggested that therapeutic PEG placement is useful for preventing unplanned interruption of CRT in patients with advanced head and neck cancer. After severe mucositis and inadequate oral intake have developed during CRT, PEG placement should be considered before the radiation therapy dose of 30 Gy.

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“…3 We found that total treatment time and baseline hemoglobin level were significant predictors for locoregional failure.…”

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confidence: 69%

Pretreatment nutritional status and locoregional failure of patients with head and neck cancer undergoing definitive concurrent chemoradiation therapy

et al. 2010

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Background This study was carried out to determine if markers of nutritional status predict for locoregional failure following intensity-modulated radiation therapy (IMRT) with concurrent chemoradiotherapy (CCRT) for squamous cell carcinoma of the head and neck (SCCHN). Methods We performed a retrospective chart review of 78 patients with SCCHN who received definitive CCRT. We compared patient factors, tumor characteristics, and nutritional status indicators between patients with and without locoregional failure. Results Fifteen of 78 patients (19%) experienced locoregional failure. Median follow-up for live patients was 38 months. On univariate analysis, pretreatment percentage of ideal body weight (%IBW) (p < .01), pretreatment hemoglobin (p = .04), and treatment duration (p < .01) were significant predictors of failure. On multivariate analysis, pretreatment %IBW (p = .04) and treatment time (p < .01) remained statistically significant. Conclusions Although treatment time is an accepted risk factor for failure, differences in outcome for patients with head and neck cancer undergoing definitive CCRT based on pre-treatment %IBW should be examined further.

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Radiation Treatment Interruptions Greater Than One Week and Low Hemoglobin Levels (12 g/dL) are Predictors of Local Regional Failure After Definitive Concurrent Chemotherapy and Intensity-Modulated Radiation Therapy for Squamous Cell Carcinoma of the Head and Neck

Abstract: Overall radiation treatment time and pretreatment hemoglobin level were significant predictors for loco-regional failure after definitive concurrent chemotherapy and IMRT for SCCHN.

Cited by 57 publications

References 29 publications

Prognosis in head and neck cancer: the importance of the patient-, and treatment-related factors

Prognosis in head and neck cancer: the importance of the patient-, and treatment-related factors

Efficacy of percutaneous endoscopic gastrostomy on unplanned treatment interruption and nutritional status in patients undergoing chemoradiotherapy for advanced head and neck cancer

Pretreatment nutritional status and locoregional failure of patients with head and neck cancer undergoing definitive concurrent chemoradiation therapy

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