Cannon Donald M, Geye Heather M, Hartig Gregory K, Traynor Anne M, Hoang Tien, McCulloch Timothy M, Wiederholt Peggy A, Chappell Richard J, Harari Paul M
Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Head Neck. 2014 Aug;36(8):1120-5. doi: 10.1002/hed.23419. Epub 2013 Nov 27.
Prolonged radiation treatment time (RTT) in head and neck squamous cell carcinoma (HNSCC) is associated with inferior tumor control in patients treated with radiation therapy (RT) alone. However, the significance of prolonged RTT with concurrent chemotherapy is less clear.
We reviewed outcomes for 171 patients with primary HNSCC treated with curative intent RT and concurrent drug therapy from 2001 to 2009. The effects of RTT and other variables on local control and survival were analyzed.
Patients with RTT >7 weeks had a significantly increased risk of local failure (hazard ratio [HR], 2.6; p = .018) and death (HR, 1.9 p = .035). These results retained significance even after adjustment for tumor stage (age was not significant).
For patients treated with concurrent chemoradiotherapy (chemoRT), prolonged RTT may compromise tumor control as has been established in the setting of RT alone. Symptoms of patients with HNSCC undergoing definitive chemoRT should be managed aggressively to limit treatment interruptions.
头颈部鳞状细胞癌（HNSCC）患者放疗时间延长（RTT）与单纯放疗（RT）患者较差的肿瘤控制相关。然而，同步化疗时RTT延长的意义尚不清楚。
我们回顾了2001年至2009年171例接受根治性放疗和同步药物治疗的原发性HNSCC患者的治疗结果。分析了RTT和其他变量对局部控制和生存的影响。
RTT>7周的患者局部失败风险显著增加（风险比[HR]，2.6；p = 0.018），死亡风险增加（HR，1.9；p = 0.035）。即使在调整肿瘤分期后（年龄无显著影响），这些结果仍具有显著性。
对于接受同步放化疗（chemoRT）的患者，延长RTT可能会损害肿瘤控制，这与单纯放疗时的情况一致。应积极处理接受根治性chemoRT的HNSCC患者的症状，以减少治疗中断。
