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Stage III and IV Head and Neck Cancer: Does Everyone Need Chemotherapy?

International Journal of Otolaryngology and Head & Neck Surgery 2014年第1期3卷 26-28页

作者： gaurav marwaha William L. Barrett Department of Radiation Oncology University of Cincinnati College of Medicine Cincinnati USA

Objectives: Definitive treatment of Stage III and IV squamous cell carcinoma can be with surgical resection, definitive radiation therapy alone or combined radiation therapy with chemotherapy. Radiation and concomitant platinum-based chemotherapy are the accepted gold standard. The purpose of this study was to determine how often patients treated with radiation therapy alone developed locoregionally recurrent disease that in retrospect possibly could have been prevented with the addition of chemotherapy. Methods: 116 consecutive patients with known Stage III and Stage IV head and neck cancers were treated with curative intent with radiation therapy alone. Results of the treatment were retrospectively reviewed. Results: Of the 116 patients treated with radiation alone, 11 (9.48%) died from locally recurrent disease, 6 (5.17%) died from local disease and were never disease-free, 7 (6.03%) died from metastatic disease, 9 (7.75%) died from disease NOS, 6 (5.17%) died from secondary malignancy, 10 (8.62%) died from ICD (2 oropharynx;8 larynx), 6 (5.17%) died from uncertain causes, 51 (43.96%) are alive and disease-free, and 10 (8.62%) patients’ final outcome data were not recoverable. Conclusions: Cure rates in selected patients with advanced head and neck cancer may be similar with radiation alone compared to radiation with the addition of chemotherapy.

关键词： Head and Neck Cancer Concurrent Chemoradiation Definitive Radiation

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