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Rønn Hansen C, Price G, Field M, Sarup N, Zukauskaite R, Johansen J, Eriksen JG, Aly F, McPartlin A, Holloway L, Thwaites D, Brink C. Larynx cancer survival model developed through open-source federated learning. Radiother Oncol 2022; 176:179-186. [PMID: 36208652 DOI: 10.1016/j.radonc.2022.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/12/2022] [Accepted: 09/28/2022] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Federated learning has the potential to perfrom analysis on decentralised data; however, there are some obstacles to survival analyses as there is a risk of data leakage. This study demonstrates how to perform a stratified Cox regression survival analysis specifically designed to avoid data leakage using federated learning on larynx cancer patients from centres in three different countries. METHODS Data were obtained from 1821 larynx cancer patients treated with radiotherapy in three centres. Tumour volume was available for all 786 of the included patients. Parameter selection among eleven clinical and radiotherapy parameters were performed using best subset selection and cross-validation through the federated learning system, AusCAT. After parameter selection, β regression coefficients were estimated using bootstrap. Calibration plots were generated at 2 and 5-years survival, and inner and outer risk groups' Kaplan-Meier curves were compared to the Cox model prediction. RESULTS The best performing Cox model included log(GTV), performance status, age, smoking, haemoglobin and N-classification; however, the simplest model with similar statistical prediction power included log(GTV) and performance status only. The Harrell C-indices for the simplest model were for Odense, Christie and Liverpool 0.75[0.71-0.78], 0.65[0.59-0.71], and 0.69[0.59-0.77], respectively. The values are slightly higher for the full model with C-index 0.77[0.74-0.80], 0.67[0.62-0.73] and 0.71[0.61-0.80], respectively. Smoking during treatment has the same hazard as a ten-years older nonsmoking patient. CONCLUSION Without any patient-specific data leaving the hospitals, a stratified Cox regression model based on data from centres in three countries was developed without data leakage risks. The overall survival model is primarily driven by tumour volume and performance status.
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Affiliation(s)
- Christian Rønn Hansen
- Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Danish Centre for Particle Therapy, Aarhus University Hospital, Denmark; Institute of Medical Physics, School of Physics, University of Sydney, Sydney, Australia.
| | - Gareth Price
- Radiotherapy department, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Matthew Field
- Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Nis Sarup
- Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark
| | - Ruta Zukauskaite
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Jørgen Johansen
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Jesper Grau Eriksen
- Department of Oncology, Odense University Hospital, Odense, Denmark; Department of Experimental Clinical Oncology, Aarhus University Hospital, Denmark; Department of Oncology, Aarhus University Hospital, Denmark
| | - Farhannah Aly
- Ingham Institute for Applied Medical Research, Sydney, Australia; Southwest Sydney Clinical Campus, University of New South Wales, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia
| | - Andrew McPartlin
- Radiotherapy department, The Christie NHS Foundation Trust, Manchester, United Kingdom
| | - Lois Holloway
- Institute of Medical Physics, School of Physics, University of Sydney, Sydney, Australia; Ingham Institute for Applied Medical Research, Sydney, Australia; Southwest Sydney Clinical Campus, University of New South Wales, Sydney, Australia; Liverpool and Macarthur Cancer Therapy Centres, Sydney, Australia
| | - David Thwaites
- Institute of Medical Physics, School of Physics, University of Sydney, Sydney, Australia
| | - Carsten Brink
- Laboratory of Radiation Physics, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark
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Sinha S, Agarwal JP, Mahajan A, Chaturvedi P, Balaji A, Juvekar S, Gupta T, Budrukkar A, Murthy V, Mummudi N, Swain M, Jadhav R, Laskar SG. Implications of limited exolaryngeal disease and cricoarytenoid joint involvement in organ conservation protocols for laryngopharyngeal cancers: Results from a prospective study. Head Neck 2020; 43:1289-1299. [PMID: 33368793 DOI: 10.1002/hed.26593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/13/2020] [Accepted: 12/17/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND To identify clinicoradiological factors that determine functional outcomes in laryngopharyngeal cancers treated with chemoradiotherapy. METHODS One hundred patients of locally advanced laryngopharyngeal cancers who were treated with chemoradiotherapy were accrued in this prospective study. The coprimary endpoint of the study was local control (LC) and functional larynx preservation survival (FLPS). RESULTS The median follow-up was 39 months. Thirty-nine patients had a local failure of which 17 underwent a salvage laryngectomy. A dysfunctional larynx with clinic-radiologically disease was seen in only 1 patient. Factors significant for LC were thyroid cartilage erosion/lysis and cricoarytenoid joint involvement. Within the T4a subset, patients with exolaryngeal disease through the soft tissue framework had significantly better LC and FLPS than those with cartilage erosion/lysis. CONCLUSIONS Patients with limited exolaryngeal disease through the soft-tissue framework can be considered for functional organ preservation, while those with thyroid cartilage involvement and cricoarytenoid joint involvement are not suitable.
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Affiliation(s)
- Shwetabh Sinha
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Jai Prakash Agarwal
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Abhishek Mahajan
- Department of Radio-Diagnosis, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Pankaj Chaturvedi
- Department of Head & Neck Surgery, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Arun Balaji
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Shashikant Juvekar
- Department of Radio-Diagnosis, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Tejpal Gupta
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Ashwini Budrukkar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Vedang Murthy
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Naveen Mummudi
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Monali Swain
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Rakesh Jadhav
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Sarbani Ghosh Laskar
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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de Andrade NMM, Dedivitis RA, Ramos DM, Matos LL, Garcia MRT, Conti GG, Kowalski LP. Tumor volume as a prognostic factor of locally advanced laryngeal cancer. Eur Arch Otorhinolaryngol 2020; 278:1627-1635. [PMID: 33095433 DOI: 10.1007/s00405-020-06438-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE The TNM tumor staging system is the most widely used for laryngeal cancer. However, in the same T stage, lesions with different primary tumor volumes (TV) can be found, impacting treatment outcomes. METHODS 145 patients with T3 and T4a laryngeal cancer, according to Union for International Cancer Control, who underwent surgical treatment from 2008 to 2017, were analyzed. TV measurements were collected and compared to different outcomes. RESULTS The mean TV was 23.0 ± 16.4 cm3. A cutoff point for TV of 14.2 cm3 was established. Cumulative sample 5-year overall survival (OS) was 62.1%, while 5-years disease-free survival (DFS) was 65.5%. In univariate analysis, TV ≥ 14.2 cm3 was associated with a higher risk of distant metastases (p = 0.045), and worse rates of OS (p = 0.009) and DFS (p = 0.035). In multivariate analysis, TV was not an independent risk factor of worse DFS (p = 0.569) or OS (p = 0.094). CONCLUSION Primary lesion TV showed significant association, in univariate analysis, with worse rates of recurrence and survival in advanced laryngeal cancer undergoing surgical treatment and can be a promising prognostic for these patients.
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Affiliation(s)
- Natália Martins Magacho de Andrade
- Department of Head and Neck Surgery, Instituto Central, University of Sao Paulo Medical School, 8° andar. Cerqueira César, São Paulo, 05403-000, Brazil.
| | - Rogério Aparecido Dedivitis
- Department of Head and Neck Surgery, Instituto Central, University of Sao Paulo Medical School, 8° andar. Cerqueira César, São Paulo, 05403-000, Brazil
| | | | - Leandro Luongo Matos
- Department of Head and Neck Surgery, Instituto Central, University of Sao Paulo Medical School, 8° andar. Cerqueira César, São Paulo, 05403-000, Brazil
- Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | | | - Gustavo Gonçalves Conti
- Department of Radiology, Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery, University of Sao Paulo Medical School, Sao Paulo, Brazil
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Dua B, Chufal KS, Bhatnagar A, Thakwani A. Nodal volume as a prognostic factor in locally advanced head and neck cancer: Identifying candidates for elective neck dissection after chemoradiation with IGRT from a single institutional prospective series from the Indian subcontinent. Oral Oncol 2018; 87:179-185. [DOI: 10.1016/j.oraloncology.2018.10.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 10/27/2022]
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Matuschek C, Bölke E, Geigis C, Kammers K, Ganswindt U, Scheckenbach K, Gripp S, Simiantonakis J, Hoffmann TK, Greve J, Gerber PA, Orth K, Roeder H, Hautmann MG, Budach W. Influence of dosimetric and clinical criteria on the requirement of artificial nutrition during radiotherapy of head and neck cancer patients. Radiother Oncol 2016; 120:28-35. [PMID: 27296411 DOI: 10.1016/j.radonc.2016.05.017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2015] [Revised: 05/02/2016] [Accepted: 05/10/2016] [Indexed: 01/08/2023]
Abstract
PURPOSE/OBJECTIVE(S) Intensification of radiotherapy and chemotherapy for head-and-neck cancer (HNC) may lead to increased rates of long term dysphagia as a severe side effect. Mucositis and consequent swallowing problems require artificial nutrition in many HNC patients undergoing radiotherapy or chemoradiation. It is unknown, which predict factors for prophylactic PEG tube insertion appear useful. MATERIALS/METHODS From an institutional database, 101 patients (72 male, 29 female, mean age 59.5years) were identified who underwent radiotherapy or chemoradiation for HNC. Primary end point of the investigation was the need for artificial nutrition for more than 4days during radiotherapy. Dose volume parameters of defined normal tissue structures potentially of relevance for swallowing ability as well as clinical factors were used to develop a predictive model using a binary multiple logistic regression model. RESULTS Whereas several dosimetric and clinical factors were significant predictors for the need of artificial nutrition on univariate analysis, on multivariate analysis only three factors remained independently significant: mean dose to the oropharynx+1cm circumferential margin, ECOG performance state (0-1 vs. 2-4), and the use of chemotherapy (yes vs. no). CONCLUSIONS Using a 3 parameter model we could distinguish HNC-patients with different risks for the need of artificial nutrition during radiotherapy. After independent validation, the model could be helpful to decision on prophylactic PEG tube insertion.
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Affiliation(s)
- Christiane Matuschek
- Department of Radiation Oncology, Medical Faculty Heinrich Heine University Hospital Duesseldorf, Germany.
| | - Edwin Bölke
- Department of Radiation Oncology, Medical Faculty Heinrich Heine University Hospital Duesseldorf, Germany
| | - Caroline Geigis
- Department of Radiation Oncology, Medical Faculty Heinrich Heine University Hospital Duesseldorf, Germany
| | - Kai Kammers
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Ute Ganswindt
- Department of Radiation Oncology, Ludwig Maximilians University Hospital, Großhadern and Campus, Germany
| | - Kathrin Scheckenbach
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Heinrich Heine University Hospital Duesseldorf, Germany
| | - Stephan Gripp
- Department of Radiation Oncology, Medical Faculty Heinrich Heine University Hospital Duesseldorf, Germany
| | - Jannis Simiantonakis
- Department of Radiation Oncology, Medical Faculty Heinrich Heine University Hospital Duesseldorf, Germany
| | - Thomas K Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, Germany
| | - Peter Arne Gerber
- Department of Dermatology, Medical Faculty Heinrich Heine University Duesseldorf, Germany
| | - Klaus Orth
- Department of General, Visceral and Thoracic Surgery, Harzkliniken Goslar, Germany
| | - Henning Roeder
- Department of Radiation Oncology, Medical Faculty Heinrich Heine University Hospital Duesseldorf, Germany
| | | | - Wilfried Budach
- Department of Radiation Oncology, Medical Faculty Heinrich Heine University Hospital Duesseldorf, Germany
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Ahlawat P, Rawat S, Kakria A, Pal M, Chauhan D, Tandon S, Jain S. Tumour volumes: Predictors of early treatment response in locally advanced head and neck cancers treated with definitive chemoradiation. Rep Pract Oncol Radiother 2016; 21:419-26. [PMID: 27489511 DOI: 10.1016/j.rpor.2016.04.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 04/08/2016] [Indexed: 11/22/2022] Open
Abstract
AIM To analyse and predict early response 3 months post definitive chemoradiation (CCRT) utilising tumour volume (TV) measurement in locally advanced head and neck cancers (LAHNC). BACKGROUND LAHNC are 3-dimentional lesions. The largest diameter of these tumours measured for T-classification may not necessarily reflect the true tumour dimensions. TV accurately reflects the tumour burden because it is a measurement of tumour burden in all three dimensions. MATERIALS AND METHODS It is a single institutional prospective study including 101 patients with LAHNC treated with definitive CCRT. TV data noted were primary tumour volume (PTV), total nodal volume (TNV) and total tumour volume (TTV). Response evaluation was done at 3 months after the completion of definitive CCRT and patients were categorised either having achieved complete response (CR) or residual disease. RESULTS Patients who had not achieved CR were found to have larger TV compared with those who had achieved CR. There were significant inverse correlations between PTV and response (median 16.37 cm(3) vs. 45.2 cm(3); p = 0.001), and between TTV and response (median 36.14 cm(3) vs. 66.06 cm(3); p < 0.001). Receiver operating characteristic (ROC) analysis identified an "optimal cut-off" value of 41 cm(3) for PTV and 42 cm(3) for TTV above and below which the magnitude of difference in response was the greatest. CONCLUSIONS If response evaluation 3 months post CCRT is to be predicted it is simply not enough to measure the largest single dimension of the tumour. TV seems to be a better and more accurate reflection of the true total tumour burden or extent of the disease.
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Lodder WL, Gilhuijs KGA, Lange CAH, Pameijer FA, Balm AJM, van den Brekel MWM. Semi-automated primary tumor volume measurements by dynamic contrast-enhanced MRI in patients with head and neck cancer. Head Neck 2012; 35:521-6. [DOI: 10.1002/hed.22988] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2012] [Indexed: 11/09/2022] Open
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Lodder WL, Pameijer FA, Rasch CRN, van den Brekel MWM, Balm AJM. Prognostic significance of radiologically determined neck node volume in head and neck cancer: a systematic review. Oral Oncol 2011; 48:298-302. [PMID: 22112442 DOI: 10.1016/j.oraloncology.2011.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Accepted: 11/01/2011] [Indexed: 11/19/2022]
Abstract
This systematic review addresses the prognostic significance of neck node volume in head and neck cancer. Primary tumor volume evolved as an independent significant factor for survival in head and neck cancer patients. Besides primary tumor volume, multiple prognostic features related to the regional lymph nodes were studied in literature. In literature, some authors showed the significance of total tumor volume/nodal volume for survival and loco-regional control. Articles reporting prognosis and survival in nodal tumor volumes were collected by systematically reviewing publications listed in the Pubmed and Embase databases. Publications were included when they at least reported on total tumor volume (TTV) or nodal volume and survival. In this systematic review we studied 21 articles. For measurement of nodal volume different formulas were used. Until now, there's no clear statistical evidence for the use of either TTV or nodal volume versus primary tumor volume to predict the individual loco-regional control or survival after treatment. There is wide variety of tumor measuring systems in the literature. The cut-off value for local tumor response also shows large variation. Firstly consensus should be accomplished on standardization of volume measurements, preferably automatic, and secondly large study groups are needed with identical treatment modalities to further unravel the role of neck node volume as separate staging tool.
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Affiliation(s)
- W L Lodder
- Department of Head & Neck Oncology and Surgery, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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Li J, Yang X, Wang S, Tang Q. Prognostic role of epidermal growth factor-like domain 7 protein expression in laryngeal squamous cell carcinoma. J Laryngol Otol 2011; 125:1152-7. [DOI: 10.1017/s0022215111002441] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:This study aimed to retrospectively analyse the expression of epidermal growth factor-like domain 7 protein in cases of laryngeal squamous cell carcinoma.Methods:We studied 116 patients retrospectively. Expression of epidermal growth factor-like domain 7 protein was determined in tumour and nontumour tissue samples, by immunohistochemistry.Results:Expression levels were significantly increased in 94 cases. Increased expression levels correlated well with tumour stage (p = 0.001) and lymph node metastasis (p = 0.002). Log-rank survival testing showed a significant difference between patients with marked versus limited expression levels (p = 0.03). Multivariable Cox regression analysis showed that epidermal growth factor-like domain 7 protein expression level was an independent predictor of laryngeal squamous cell carcinoma prognosis.Conclusion:These findings provide evidence that increased epidermal growth factor-like domain 7 protein expression is associated with laryngeal squamous cell carcinoma stage, lymph node metastasis and poor survival. This suggests that this protein may be a potential marker for laryngeal squamous cell carcinoma.
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Knegjens JL, Hauptmann M, Pameijer FA, Balm AJ, Hoebers FJ, de Bois JA, Kaanders JH, van Herpen CM, Verhoef CG, Wijers OB, Wiggenraad RG, Buter J, Rasch CR. Tumor volume as prognostic factor in chemoradiation for advanced head and neck cancer. Head Neck 2011; 33:375-82. [PMID: 20629076 DOI: 10.1002/hed.21459] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Tumor volume is an important predictor of outcome in radiotherapy alone. Its significance in concomitant chemoradiation (CCRT) is much less clear. We analyzed the prognostic value of primary tumor volume for advanced head and neck squamous cell carcinoma (HNSCC) treated with CCRT. METHODS Three hundred sixty patients treated with definitive CCRT for advanced HNSCC were selected. The pretreatment MRI or CT scan was used to calculate the primary tumor volume. Median follow-up was 19.8 months. RESULTS The average primary tumor volume was 37.0 cm³ (range, 2.1-182.7 cm³; median, 28.7 cm³). Multivariate analysis showed a significant effect of tumor volume on local control. The hazard ratio for a local recurrence increased by 14% per 10 cm³ volume increase (95% CI, 8% to 21%). There was no significant independent effect of T and N status on local control. CONCLUSION For advanced HNSCC, tumor volume is more powerful for predicting outcome after CCRT than TNM status.
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Affiliation(s)
- Joost L Knegjens
- Department of Radiation Oncology, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
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Yu KH, Yu SCH, Hui EP, Kam MKM, Vlantis AC, Yuen E, Chan ATC. Accelerated fractionation radiotherapy and late intensification with 2 intra-arterial cisplatin infusions for locally advanced head and neck squamous cell carcinoma. Head Neck 2010; 32:913-20. [PMID: 19885925 DOI: 10.1002/hed.21279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND This study was established to determine the maximum tolerated dose of intra-arterial cisplatin (IAC) concurrent with accelerated fractionation radiotherapy for locally advanced head and neck squamous cell carcinoma (HNSCC). METHODS We conducted a phase I study. Treatment consisted of 70 Gy/35 fractions/5.8 weeks and 2 weekly IAC infusions during the last 2 weeks. RESULTS Ten patients were recruited. Two patients had stage III, 1 had stage IVa, and 7 had stage IVb disease. Three patients received IAC at 100 mg/m(2), 3 at 125 mg/m(2), and 4 at 150 mg/m(2). Nine patients received both planned infusions. Dose-limiting toxicity occurred at 150 mg/m(2) as transient grade 4 leukopenia and prolonged grade 3 acute skin reactions. The maximum tolerated dose was 125 mg/m(2). Six patients survived disease-free at 39 to 67 months. CONCLUSIONS It was feasible to give IAC concurrent with accelerated fractionation radiotherapy for locally advanced HNSCC. The maximum tolerated dose of cisplatin was 125 mg/m(2).
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Affiliation(s)
- Kwok Hung Yu
- Department of Clinical Oncology, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong.
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de Jong MC, Pramana J, Knegjens JL, Balm AJ, van den Brekel MW, Hauptmann M, Begg AC, Rasch CR. HPV and high-risk gene expression profiles predict response to chemoradiotherapy in head and neck cancer, independent of clinical factors. Radiother Oncol 2010; 95:365-70. [DOI: 10.1016/j.radonc.2010.02.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2009] [Revised: 02/01/2010] [Accepted: 02/03/2010] [Indexed: 01/12/2023]
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Hoebers FJP, Pameijer FA, de Bois J, Heemsbergen W, Balm AJM, Schornagel JH, Rasch CRN. Prognostic value of primary tumor volume after concurrent chemoradiation with daily low-dose cisplatin for advanced-stage head and neck carcinoma. Head Neck 2008; 30:1216-23. [DOI: 10.1002/hed.20865] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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