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Adjuvant radiotherapy after transoral laser microsurgery for advanced squamous carcinoma of the head and neck.
Int J Radiat Oncol Biol Phys. 2005 Dec 01; 63(5):1368-77.IJ

Abstract

PURPOSE

To evaluate the efficacy of an adjuvant radiotherapy after transoral laser microsurgery for advanced squamous cell carcinoma of the head and neck and to show that a less invasive surgery with organ preservation in combination with radiotherapy is an alternative to a radical treatment.

PATIENTS AND METHODS

Between 1987 and 2000, 208 patients with advanced squamous cell carcinoma of the head and neck were treated with postoperative radiotherapy after surgical CO2 laser resection. Primary sites included oral cavity, 38; oropharynx, 88; larynx, 36; hypopharynx, 46. Disease stages were as follows: Stage III, 40 patients; Stage IV, 168 patients. Before 1994, the treatment consisted of a split-course radiotherapy with carboplatinum (Treatment A). After 1994, the patients received a conventional radiotherapy (Treatment B).

RESULTS

Patients had 5-year locoregional control and disease-specific survival (DSS) rates of 68% and 48%, respectively. The 5-year DSS was 70% and 44% for Stages III and IV, respectively (p = 0.00127). Patients treated with a hemoglobin level greater or equal to 13.5 g/dL before radiotherapy had a 5-year DSS of 55% as compared with 39% for patients treated with a hemoglobin level greater than 13.5 g/dL (p = 0.0054).

CONCLUSION

In this series of patients with advanced head-and-neck tumors, transoral laser surgery in combination with adjuvant radiotherapy resulted in locoregional control and DSS rates similar to those reported for radical surgery followed by radiotherapy. Treatment B has clearly been superior to Treatment A. A further improvement of our treatment regimen might be expected by the combination of adjuvant radiotherapy with concomitant platinum-based chemotherapy.

Authors+Show Affiliations

Department of Radiotherapy, University of Göttingen, Göttingen, Germany. opradier@gwdg.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

16169679

Citation

Pradier, Olivier, et al. "Adjuvant Radiotherapy After Transoral Laser Microsurgery for Advanced Squamous Carcinoma of the Head and Neck." International Journal of Radiation Oncology, Biology, Physics, vol. 63, no. 5, 2005, pp. 1368-77.
Pradier O, Christiansen H, Schmidberger H, et al. Adjuvant radiotherapy after transoral laser microsurgery for advanced squamous carcinoma of the head and neck. Int J Radiat Oncol Biol Phys. 2005;63(5):1368-77.
Pradier, O., Christiansen, H., Schmidberger, H., Martin, A., Jäckel, M. C., Steiner, W., Ambrosch, P., Kahler, E., & Hess, C. F. (2005). Adjuvant radiotherapy after transoral laser microsurgery for advanced squamous carcinoma of the head and neck. International Journal of Radiation Oncology, Biology, Physics, 63(5), 1368-77.
Pradier O, et al. Adjuvant Radiotherapy After Transoral Laser Microsurgery for Advanced Squamous Carcinoma of the Head and Neck. Int J Radiat Oncol Biol Phys. 2005 Dec 1;63(5):1368-77. PubMed PMID: 16169679.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adjuvant radiotherapy after transoral laser microsurgery for advanced squamous carcinoma of the head and neck. AU - Pradier,Olivier, AU - Christiansen,Hans, AU - Schmidberger,Heinz, AU - Martin,Alexios, AU - Jäckel,Martin C, AU - Steiner,Wolfgang, AU - Ambrosch,Petra, AU - Kahler,Elke, AU - Hess,Clemens F, Y1 - 2005/09/19/ PY - 2004/08/20/received PY - 2005/04/27/revised PY - 2005/05/11/accepted PY - 2005/9/20/pubmed PY - 2006/1/10/medline PY - 2005/9/20/entrez SP - 1368 EP - 77 JF - International journal of radiation oncology, biology, physics JO - Int J Radiat Oncol Biol Phys VL - 63 IS - 5 N2 - PURPOSE: To evaluate the efficacy of an adjuvant radiotherapy after transoral laser microsurgery for advanced squamous cell carcinoma of the head and neck and to show that a less invasive surgery with organ preservation in combination with radiotherapy is an alternative to a radical treatment. PATIENTS AND METHODS: Between 1987 and 2000, 208 patients with advanced squamous cell carcinoma of the head and neck were treated with postoperative radiotherapy after surgical CO2 laser resection. Primary sites included oral cavity, 38; oropharynx, 88; larynx, 36; hypopharynx, 46. Disease stages were as follows: Stage III, 40 patients; Stage IV, 168 patients. Before 1994, the treatment consisted of a split-course radiotherapy with carboplatinum (Treatment A). After 1994, the patients received a conventional radiotherapy (Treatment B). RESULTS: Patients had 5-year locoregional control and disease-specific survival (DSS) rates of 68% and 48%, respectively. The 5-year DSS was 70% and 44% for Stages III and IV, respectively (p = 0.00127). Patients treated with a hemoglobin level greater or equal to 13.5 g/dL before radiotherapy had a 5-year DSS of 55% as compared with 39% for patients treated with a hemoglobin level greater than 13.5 g/dL (p = 0.0054). CONCLUSION: In this series of patients with advanced head-and-neck tumors, transoral laser surgery in combination with adjuvant radiotherapy resulted in locoregional control and DSS rates similar to those reported for radical surgery followed by radiotherapy. Treatment B has clearly been superior to Treatment A. A further improvement of our treatment regimen might be expected by the combination of adjuvant radiotherapy with concomitant platinum-based chemotherapy. SN - 0360-3016 UR - https://www.unboundmedicine.com/medline/citation/16169679/Adjuvant_radiotherapy_after_transoral_laser_microsurgery_for_advanced_squamous_carcinoma_of_the_head_and_neck_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(05)00892-8 DB - PRIME DP - Unbound Medicine ER -