Routine feasibility of postoperative chemoradiotherapy in head and neck squamous cell carcinoma at high risk of recurrence

Routine feasibility of postoperative chemoradiotherapy in head and neck squamous cell carcinoma at high risk of recurrence:



Publication date: Available online 11 April 2020

Source: European Annals of Otorhinolaryngology, Head and Neck Diseases

Author(s): M. Humbert, M. De La Losa, B. Gery, C. Florescu, J. Thariat, A. Rambeau



Author links open overlay panelM.HumbertabM.De La LosaabB.GerycC.FlorescucJ.ThariatcdA.Rambeaue

a

Chirurgie ORL, Centre François-Baclesse, Caen, France

b

Chirurgie ORL, Centre Hospitalier Universitaire, Caen, France

c

Radiothérapie, Centre François-Baclesse, Caen, France

d

Université de Caen Normandie, Caen, France

e

Oncologie Médicale, Centre François-Baclesse, Caen, France

Available online 11 April 2020.



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https://doi.org/10.1016/j.anorl.2020.03.012Get rights and content

Abstract

Objective

To assess the feasibility in routine practice of postoperative chemoradiotherapy in head and neck squamous cell carcinoma (HNSCC) at high risk of recurrence.



Method

A single-center retrospective study recruited all patients receiving postoperative cisplatin chemoradiotherapy for HNSCC at high risk of recurrence. The main endpoints were the rate of complete postoperative chemoradiotherapy and the impact of various clinical factors. Secondary endpoints comprised the impact of completion of therapy on survival and on acute and late toxicity.



Results

One hundred and six patients were included. 24.5% showed severe comorbidity. Chemoradiotherapy was complete in 61 patients (57.5%). Radiation therapy was interrupted for > 3 days in 16 patients (15.1%). The 3rd concomitant cisplatin course could not be implemented in 34 patients (32.1%). Low pre-treatment glomerular filtration rate was significantly associated (p = 0.003) with treatment interruption; > 5% weight-loss during treatment showed suggestive association (p = 0.026). Completion of treatment was not associated with any significant difference in overall survival (p = 0.441) or progression-free survival (p = 0.81). 14.9% of patients showed post-treatment kidney failure; there were 10 cases of osteoradionecrosis (9.4%).



Conclusion

The rate of complete postoperative chemoradiotherapy was comparable to that reported in clinical trials, despite frequent comorbidity and poor nutritional status. Early nutritional support is a key factor for treatment under optimal conditions.



Keywords

Advanced head and neck cancerPostoperative chemoradiotherapySquamous cell carcinomaAdjuvant treatmentTreatment interruption

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