Prognostic Factors After Definitive Radio(Chemo)Therapy of Locally Advanced Head and Neck Cancer

Abstract

Aim: To identify predictors of locoregional control (LRC) and overall survival (OS) after definitive radio(chemo)therapy for squamous cell carcinoma of the head and neck (SCCHN).

Patients and methods: Two hundred and seventy-five patients were evaluated; 261 patients received radiochemotherapy with 30-40 mg/m(2) of cisplatin weekly, three courses of cisplatin 100 mg/m(2), two courses of cisplatin 5x20 mg/m(2) or two courses of cisplatin 5×20 mg/m(2)plus 5-fluorouracil. Ten characteristics were analyzed: Pre-radiotherapy hemoglobin, T-/N-category, Karnofsky performance-score (KPS), gender, age, chemotherapy type, tumor site, grading and radiation dose.

Results: On multivariate analyses, hemoglobin 12-14 g/dl (p=0.040), lower T-category (p=0.010), lower N-category (p=0.042) and female gender (p=0.006) were predictive of LRC. Hemoglobin >12 g/dl (p=0.020), lower N-category (p<0.001), KPS ≥80 (p<0.001), female gender (p=0.024) and cisplatin 100 mg/m(2) or 5×20 mg/m(2) (p<0.001) were predictors of improved OS.

Conclusion: Predictors of LRC and OS were identified that can improve personalization of treatment. Since chemotherapy type was associated with OS, studies comparing different regimens are warranted.

Keywords: Locally advanced SCCHN; definitive radio(chemo) therapy; locoregional control; overall survival; prognostic factors.