Predictors of severe late radiotherapy-related toxicity after hyperfractionated radiotherapy with or without concomitant cisplatin in locally advanced head and neck cancer. Secondary retrospective analysis of a randomized phase III trial (SAKK 10/94)
Predictors of severe late radiotherapy-related toxicity after hyperfractionated radiotherapy with or without concomitant cisplatin in locally advanced head and neck cancer. Secondary retrospective analysis of a randomized phase III trial (SAKK 10/94)
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DOI：
10.1016/j.radonc.2012.05.004
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发表时间：
2012-08-01
影响因子：
5.7
通讯作者：
Aebersold, Daniel M.
中科院分区：
文献类型：
--
作者：
Ghadjar, Pirus;Simcock, Mathew;Aebersold, Daniel M.
背景和目的：进行二次分析，以确定预测因素的严重晚期放疗（RT）相关的毒性治疗后与超分割RI +/-伴随顺铂在局部晚期头颈cancer.Materials和方法：患者进行了回顾性分析，从以前报道的随机III期试验：SAKK 10/94。严重的晚期RI相关的毒性被定义为晚期RTOG 3级毒性开始3个月后结束的RT和/或潜在的治疗相关的死亡在3年内的randomization.Results：213例随机患者进行了分析，84（39%）经历了严重的晚期RT相关的毒性。中位随访时间为9.7年（范围：0.4-15.4年），至重度晚期RT相关毒性的中位时间为9.6年。在单变量考克斯比例风险模型中，以下变量与严重的晚期RT相关毒性相关：晚期N分类（p < 0.001）：技术上不可切除的疾病（p = 0.04）;体重减轻率（p = 0.003）;支持措施（p = 0.009）和严重急性吞咽困难（p = 0.001）。在随后的多变量分析中，所有的变量，除了使用的支持性measurementsstatistics.Conclusions：化疗并没有出现影响严重的晚期RT相关的毒性，但先进的N-分类，技术上无法切除的疾病，体重减轻的比例，严重的急性吞咽困难是独立的预测因素严重的晚期RT相关的毒性。(c)2012爱思唯尔爱尔兰有限公司保留所有权利。放射治疗和肿瘤学104（2012）213-218
Background and purpose: This secondary analysis was performed to identify predictive factors for severe late radiotherapy (RT)-related toxicity after treatment with hyperfractionated RI +/- concomitant cisplatin in locally advanced head and neck cancer.Materials and methods: Patients were retrospectively analyzed from the previously reported randomized phase III trial: SAKK 10/94. Severe late RI-related toxicity was defined as late RTOG grade 3 toxicity starting 3 months after end of RT and/or potential treatment-related death within 3 years of randomization.Results: Two hundred and thirteen randomized patients were analyzed; 84 (39%) experienced severe late RT-related toxicity. With median follow-up of 9.7 years (range, 0.4-15.4 years), median time to severe late RT-related toxicity was 9.6 years. In the univariate Cox proportional hazards model the following variables were associated with severe late RT-related toxicity: advanced N-classification (p < 0.001): technically unresectable disease (p = 0.04); weight loss ratio (p = 0.003); supportive measures (p = 0.009) and severe acute dysphagia (p = 0.001). In the subsequent multivariate analysis all variables except use of supportive measures remained statistically significant.Conclusions: Chemotherapy did not appear to affect severe late RT-related toxicity, but advanced N-classification, technically unresectable disease, weight loss ratio, and severe acute dysphagia were independent predictive factors for severe late RT-related toxicity. (c) 2012 Elsevier Ireland Ltd. All rights reserved. Radiotherapy and Oncology 104 (2012) 213-218