Adjuvant radiotherapy after transoral laser microsurgery for advanced squamous carcinoma of the head and neck

Journal Article · Thu Dec 01 04:00:00 EST 2005 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/J.IJROBP.2005.0· OSTI ID:20788228

Pradier, Olivier ^[1]; Christiansen, Hans ^[1]; Schmidberger, Heinz ^[1]; Martin, Alexios ^[2]; Jaeckel, Martin C ^[2]; Steiner, Wolfgang ^[2]; Ambrosch, Petra ^[2]; Kahler, Elke ^[3]; Hess, Clemens F ^[1]

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1. Department of Radiotherapy, University of Goettingen, Goettingen (Germany)
2. Department of Otorhinolaryngology, University of Goettingen, Goettingen (Germany)
3. Department of Biometry, University of Goettingen, Goettingen (Germany)

Purpose: To evaluate the efficacy of an adjuvant radiotherapy after transoral laser microsurgery for advanced squamous cell carcinoma of the head and neck and to show that a less invasive surgery with organ preservation in combination with radiotherapy is an alternative to a radical treatment. Patients and Methods: Between 1987 and 2000, 208 patients with advanced squamous cell carcinoma of the head and neck were treated with postoperative radiotherapy after surgical CO{sub 2} laser resection. Primary sites included oral cavity, 38; oropharynx, 88; larynx, 36; hypopharynx, 46. Disease stages were as follows: Stage III, 40 patients; Stage IV, 168 patients. Before 1994, the treatment consisted of a split-course radiotherapy with carboplatinum (Treatment A). After 1994, the patients received a conventional radiotherapy (Treatment B). Results: Patients had 5-year locoregional control and disease-specific survival (DSS) rates of 68% and 48%, respectively. The 5-year DSS was 70% and 44% for Stages III and IV, respectively (p = 0.00127). Patients treated with a hemoglobin level greater or equal to 13.5 g/dL before radiotherapy had a 5-year DSS of 55% as compared with 39% for patients treated with a hemoglobin level greater than 13.5 g/dL (p = 0.0054). Conclusion: In this series of patients with advanced head-and-neck tumors, transoral laser surgery in combination with adjuvant radiotherapy resulted in locoregional control and DSS rates similar to those reported for radical surgery followed by radiotherapy. Treatment B has clearly been superior to Treatment A. A further improvement of our treatment regimen might be expected by the combination of adjuvant radiotherapy with concomitant platinum-based chemotherapy.

• OSTI ID: 20788228
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 5 Vol. 63; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CARBON DIOXIDE LASERS
CARCINOMAS
CHEMOTHERAPY
HEAD
HEMOGLOBIN
LARYNX
NECK
ORAL CAVITY
PATIENTS
PLATINUM
RADIOTHERAPY
SURGERY