Thursday, June 16, 2011 (Last Updated: 06/17/2011)
THURSDAY, June 16 (HealthDay News) -- Retreatment with concurrent chemotherapy and reirradiation (CReRT) may be a treatment option for a specific group of patients with recurrent or second primary head and neck cancer (HNC), although prior treatment with chemoradiotherapy (CRT) is associated with worse overall survival (OS), according to a study published online June 13 in Cancer.
Kevin S. Choe, M.D., Ph.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues investigated the prognostic factors associated with the survival of 166 previously irradiated patients with nonmetastatic HNC. Participants were enrolled from nine consecutive phase 1 and 2 protocols for poor-prognosis HNC, and 81 underwent surgical resection or debulking before enrollment. Participants were retreated with reirradiation (ReRT) (dose 66 gray), and concurrent chemotherapy with 5-fluorouracil, hydroxyurea, and a third agent.
The investigators found that 19.9 percent of patients died due to treatment-related toxicity. The median OS was 10.3 months among surviving patients after a median follow-up of 53 months. The two-year OS rate was 24.8 percent, the disease-free survival rate was 19.9 percent, the locoregional control was 50.7 percent, and freedom from distant metastasis was 61.4 percent. Compared to CRT-naive patients, a subgroup of patients who had previously received concurrent CRT had significantly reduced two-year OS. After adjusting for confounding variables, previous treatment with CRT was independently associated with OS. Other factors associated with OS were surgery before protocol treatment, full-dose ReRT, and radiotherapy interval.
"CReRT achieved a long-term cure for a small group of patients with recurrent or second primary HNC. Previous treatment with CRT was among the important prognostic factors for survival," the authors write.
Hematology & Oncology
Copyright © 2011 HealthDay. All rights reserved.