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Title: Long-term follow-up after transoral laser microsurgery and adjuvant radiotherapy for advanced recurrent squamous cell carcinoma of the head and neck

Purpose: The aim of this study was to evaluate the efficacy of adjuvant radiotherapy after transoral laser microsurgery for advanced recurrent head-and-neck squamous cell carcinoma (HNSCC). Patients and Methods: Between 1988 and 2000, 37 patients with advanced local recurrences (23 local and 14 locoregional recurrences) of HNSCC without distant metastases were treated in curative intent with organ-preserving transoral laser microsurgery and adjuvant radiotherapy (before 1994 split-course radiotherapy with carboplatinum, after 1994 conventional radiotherapy). Initial therapy of the primary (8.1% oral cavity, 35.1% oropharynx, 13.5% hypopharynx, and 43.3% larynx) before relapse was organ-preserving transoral laser microsurgery without any adjuvant therapy. Results: After a median follow-up of 124 months, the 5-year overall survival rate was 21.3%, the loco-regional control rate 48.3%, respectively. In multivariate analysis, stage of original primary tumor (Stage I/II vs. Stage III/IV), and patient age (<58 years vs. {>=}58 years) showed statistically significant impact on prognosis. In laryngeal cancer, larynx preservation rate after treatment for recurrent tumor was 50% during follow-up. Conclusion: Our data show that organ-preserving transoral laser microsurgery followed by adjuvant radiotherapy is a curative option for patients who have advanced recurrence after transoral laser surgery and is an alternative to radical treatment.
Authors:
 [1] ;  [2] ;  [3] ;  [2] ;  [4] ;  [2] ;  [2] ;  [3] ;  [2] ;  [5]
  1. Department of Radiotherapy, University of Goettingen, Goettingen (Germany). E-mail: hchrist@gwdg.de
  2. Department of Radiotherapy, University of Goettingen, Goettingen (Germany)
  3. Department of Otorhinolaryngology, University of Goettingen, Goettingen (Germany)
  4. Department of Biometry, University of Goettingen, Goettingen (Germany)
  5. Department de Cancerologie, Hopital Morvan, Centre Hospitalier Universitaire de Brest, Brest (France)
Publication Date:
OSTI Identifier:
20849980
Resource Type:
Journal Article
Resource Relation:
Journal Name: International Journal of Radiation Oncology, Biology and Physics; Journal Volume: 65; Journal Issue: 4; Other Information: DOI: 10.1016/j.ijrobp.2006.03.007; PII: S0360-3016(06)00399-3; Copyright (c) 2006 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARCINOMAS; HEAD; LARYNX; LASERS; METASTASES; MULTIVARIATE ANALYSIS; NECK; ORAL CAVITY; PATIENTS; RADIOTHERAPY; SURGERY