Increased local failure risk with prolonged radiation treatment time in head and neck cancer treated with concurrent chemotherapy

Background Prolonged radiation treatment time (RTT) in head and neck squamous cell carcinoma (HNSCC) is associated with inferior tumor control in patients treated with radiation therapy (RT) alone. However, the significance of prolonged RTT with concurrent chemotherapy is less clear. Methods We revi...

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Bibliographic Details
Published in:Head & neck 2014-08, Vol.36 (8), p.1120-1125
Main Authors: Cannon, Donald M., Geye, Heather M., Hartig, Gregory K., Traynor, Anne M., Hoang, Tien, McCulloch, Timothy M., Wiederholt, Peggy A., Chappell, Richard J., Harari, Paul M.
Format: Article
Language:English
Subjects:
accelerated repopulation
Adult
Aged
Aged, 80 and over
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - therapy
chemoradiotherapy
Chemoradiotherapy - adverse effects
Chemoradiotherapy - methods
Female
head and neck cancer
Head and Neck Neoplasms - mortality
Head and Neck Neoplasms - therapy
Humans
Male
Middle Aged
prognostic factors
Proportional Hazards Models
Radiotherapy Dosage
Squamous Cell Carcinoma of Head and Neck
Survival Rate
Treatment Outcome
treatment time
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Summary:Background Prolonged radiation treatment time (RTT) in head and neck squamous cell carcinoma (HNSCC) is associated with inferior tumor control in patients treated with radiation therapy (RT) alone. However, the significance of prolonged RTT with concurrent chemotherapy is less clear. Methods We reviewed outcomes for 171 patients with primary HNSCC treated with curative intent RT and concurrent drug therapy from 2001 to 2009. The effects of RTT and other variables on local control and survival were analyzed. Results Patients with RTT >7 weeks had a significantly increased risk of local failure (hazard ratio [HR], 2.6; p = .018) and death (HR, 1.9 p = .035). These results retained significance even after adjustment for tumor stage (age was not significant). Conclusion For patients treated with concurrent chemoradiotherapy (chemoRT), prolonged RTT may compromise tumor control as has been established in the setting of RT alone. Symptoms of patients with HNSCC undergoing definitive chemoRT should be managed aggressively to limit treatment interruptions. © 2013 Wiley Periodicals, Inc. Head Neck 36: 1120–1125, 2014
ISSN:1043-3074
1097-0347
DOI:10.1002/hed.23419