Long-term outcome and patterns of failure in patients with advanced head and neck cancer

Radiation Oncology

Katja Lindel²  Juergen Debus²  Simone Hecht²  Christian Simon¹  Henrik Hauswald² 

[1] Department of Oto-Rhino-Laryngology, University of Heidelberg, Heidelberg, Germany;Department of Radiation Oncology, University of Heidelberg, Heidelberg, Germany

关键词: long-term follow-up;    irradiation;    radiochemotherapy;    radiotherapy;    head and neck cancer;    HNSCC;   

Others  :  1224336
DOI  :  10.1186/1748-717X-6-70

 received in 2011-01-19, accepted in 2011-06-10,  发布年份 2011

【 摘 要 】

Purpose

To access the long-time outcome and patterns of failure in patients with advanced head and neck squamous cell carcinoma (HNSCC).

Methods and materials

Between 1992 and 2005 127 patients (median age 55 years, UICC stage III n = 6, stage IV n = 121) with primarily inoperable, advanced HNSCC were treated with definite platinum-based radiochemotherapy (median dose 66.4 Gy). Analysed end-points were overall survival (OS), disease-free survival (DFS), loco-regional progression-free survival (LPFS), development of distant metastases (DM), prognostic factors and causes of death.

Results

The mean follow-up time was 34 months (range, 3-156 months), the 3-, 5- and 10-year OS rates were 39%, 28% and 14%, respectively. The median OS was 23 months. Forty-seven patients achieved a complete remission and 78 patients a partial remission. The median LPFS was 17 months, the 3-, 5- and 10-year LPFS rates were 41%, 33% and 30%, respectively. The LPFS was dependent on the nodal stage (p = 0.029). The median DFS was 11 months (range, 2-156 months), the 3-, 5- and 10-year DFS rates were 30%, 24% and 22%, respectively. Prognostic factors in univariate analyses were alcohol abuse (n = 102, p = 0.015), complete remission (n = 47, p < 0.001), local recurrence (n = 71, p < 0.001), development of DM (n = 45, p < 0.001; median OS 16 months) and borderline significance in nodal stage N2 versus N3 (p = 0.06). Median OS was 26 months with lung metastases (n = 17). Nodal stage was a predictive factor for the development of DM (p = 0.025). Cause of death was most commonly tumor progression.

Conclusions

In stage IV HNSCC long-term survival is rare and DM is a significant predictor for mortality. If patients developed DM, lung metastases had the most favourable prognosis, so intensified palliative treatment might be justified in DM limited to the lungs.

【 授权许可】

   
2011 Hauswald et al; licensee BioMed Central Ltd.

【 图 表 】

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