Parameters that predict local control after definitive radiotherapy for squamous cell carcinoma of the head and neck

• Published in: Head & neck 2003-07, Vol.25 (7), p.535-542
• Main Authors: Mendenhall, William M., Morris, Christopher G., Amdur, Robert J., Hinerman, Russell W., Mancuso, Anthony A.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biological and medical sciences; carcinoma; carcinoma, squamous cell; Carcinoma, Squamous Cell - drug therapy; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Chemotherapy, Adjuvant; Cisplatin - therapeutic use; Diseases of the upper aerodigestive tract; Ent and stomatology; Female; Fluorouracil - therapeutic use; head and neck neoplasms; Head and Neck Neoplasms - drug therapy; Head and Neck Neoplasms - pathology; Head and Neck Neoplasms - radiotherapy; Humans; Male; Medical sciences; Middle Aged; Multivariate Analysis; Neoplasm Staging; Otorhinolaryngology (head neck, general aspects and miscellaneous); Otorhinolaryngology. Stomatology; Predictive Value of Tests; radiotherapy; Radiotherapy - adverse effects; Radiotherapy Dosage; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); squamous cell; treatment planning; tumor volume; Tumors
• ISSN: 1043-3074; 1097-0347
• DOI: 10.1002/hed.10253

Purpose. To analyze parameters that may influence the likelihood of local control after definitive radiotherapy for head and neck cancer. Methods. Between April 1980 and January 2000, 404 patients were treated with definitive RT alone (358 patients) or combined with adjuvant chemotherapy (46 patients) at our institution and were followed up for 0.25 to 20.25 years (median, 3.5 years.) All living patients were followed up for at least 2 years. All patients had the primary tumor volume calculated on pretreatment CT. End points were local control after RT and local control after RT without a severe late complication. Parameters evaluated in multivariate analyses of these end points included primary site, T stage, primary tumor volume, N stage, histologic differentiation, fractionation schedule, adjuvant chemotherapy, and gender. Results. The rates of local control and local control without a severe late complication after RT were significantly influenced by primary tumor volume for patients with cancer of the supraglottic larynx and true vocal cord. In contrast, the rates of local control and local control without severe complications for patients with tumors of the oropharynx and hypopharynx were less influenced by tumor volume. Multivariate analysis of the overall population revealed that the only parameter that was significantly related to the probability of local control after RT was T stage. Multivariate analyses stratified by primary site revealed that tumor volume significantly influenced local control for patients with cancers of the supraglottis (p = .0220) and glottis (p = .0042) but not for those with lesions of the tonsillar fossa/posterior tonsillar pillar (p = .0892), base of tongue (p = .9493), anterior tonsillar pillar/soft palate (p = .5909), and hypopharynx (p = .2282). Conclusions. The most important parameter that has an impact on local control after RT is T stage. Primary tumor volume also significantly influences the probability of local control in cancers of the supraglottis and glottis. © 2003 Wiley Periodicals, Inc. Head Neck 25: 535–542, 2003