Cancer Research and Treatment

Original Articles

Adjuvant Postoperative Radiotherapy with or without Chemotherapy for Locally Advanced Squamous Cell Carcinoma of the Head and Neck: The Importance of Patient Selection for the Postoperative Chemoradiotherapy: Jong Hoon Lee, Jin Ho Song, Sang Nam Lee, Jin Hyoung Kang, Min Sik Kim, Dong Il Sun, Yeon-Sil Kim; Cancer Res Treat. 2013;45(1):31-39. Published online March 31, 2013; DOI: https://doi.org/10.4143/crt.2013.45.1.31

PURPOSE
We wanted to evaluate the role of postoperative chemoradiotherapy (CRT) for patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN).
MATERIALS AND METHODS
From March 1993 to July 2008, 101 patients with advanced SCCHN and who had undergone macroscopically complete resection were enrolled. Survival and the cumulative incidence of local or regional relapse, metastasis, and acute toxicity were analyzed.
RESULTS
There was a marginally significant difference of disease-free survival at five years in favor of the CRT arm (51.3% vs. 41.8%, respectively; p=0.10). However, there was no significant difference in overall survival between the two treatment arms (p=0.20). The rate of locoregional failure only for the radiotherapy arm was significantly higher than that for the CRT arm (23.2% vs. 4.4%, respectively; p=0.01). The incidence of grade 3 or 4 hematologic toxicity was significantly higher in the CRT arm than that in the radiotherapy arm (37.7% vs. 1.7%, respectively; p=0.01). In CRT arm, early mortality group within 1 year had low performance status and old age over sixty compared with those of the others.
CONCLUSION
After curative-intent surgery, adjuvant CRT is more effective in locoregional tumor control than radiotherapy alone for patients with advanced SCCHN. However, compared with radiotherapy alone, this combined modality treatment had no survival benefit, and was significantly associated with increased toxicity. Thus, patients with low performance status and old age must be cautious in selection of toxic trimodality treatment.

Citations

Citations to this article as recorded by

Modern management of distant metastases from head and neck squamous cell carcinoma
Patrick Bradley, Claudia Montenegro, Cesare Piazza
Current Opinion in Otolaryngology & Head & Neck Surgery.2025; 33(2): 115. CrossRef
Therapeutic Drug Monitoring of 5-Fluorouracil in Head and Neck Cancer Patients: An Interventional Pilot Study
P. Sharmila Nirojini, N.K. Bhuvaneshwari, N. Dharsshini, S. Dhivya Bharathi, K. Velavan
Indian Journal of Medical and Paediatric Oncology.2024; 45(02): 134. CrossRef
Factors Associated with Patient Survival in Clear Cell Adenocarcinoma of the Cervix: A Single-Center Experience in China
Ting Wang, Zhiying Lu, Xiaodan Zhang, Keqin Hua
International Journal of General Medicine.2022; Volume 15: 4625. CrossRef
Adding Concomitant Chemotherapy to Postoperative Radiotherapy in Oral Cavity Carcinoma with Minor Risk Factors: Systematic Review of the Literature and Meta-Analysis
Alessia Di Rito, Francesco Fiorica, Roberta Carbonara, Francesca Di Pressa, Federica Bertolini, Francesco Mannavola, Frank Lohr, Angela Sardaro, Elisa D’Angelo
Cancers.2022; 14(15): 3704. CrossRef
Metastatic disease in head & neck oncology
Paolo Pisani, Mario Airoldi, Anastasia Allais, Paolo Aluffi Valletti, Mariapina Battista, Marco Benazzo, Roberto Briatore, Salvatore Cacciola, Salvatore Cocuzza, Andrea Colombo, Bice Conti, Alberto Costanzo, Laura della Vecchia, Nerina Denaro, Cesare Fant
Acta Otorhinolaryngologica Italica.2020; 40(SUPPL. 1): S1. CrossRef
The Efficacy of Low Postoperative Radiation Dose in Patients with Advanced Hypopharyngeal Cancer without High-Risk Factors

Hengmin Tao, Zhong Shen, Zhichao Liu, Yumei Wei
Cancer Management and Research.2020; Volume 12: 7553. CrossRef
Contemporary treatment patterns and outcomes of salivary gland carcinoma: a National Cancer Database review
Jay K. Ferrell, Jess C. Mace, Daniel Clayburgh
European Archives of Oto-Rhino-Laryngology.2019; 276(4): 1135. CrossRef
Detection of high PD-L1 expression in oral cancers by a novel monoclonal antibody L1Mab-4
Shinji Yamada, Shunsuke Itai, Mika K. Kaneko, Yukinari Kato
Biochemistry and Biophysics Reports.2018; 13: 123. CrossRef
Postoperative radiotherapy dose requirement in standard combined-modality practice for head and neck squamous cell carcinoma: Analysis of salient surgical and radiotherapy parameters in 2 cohorts
Bidhu K. Mohanti, Alok Thakar, Jaspreet Kaur, Sudhir Bahadur, Monica Malik, Ajeet K. Gandhi, Suman Bhasker, Atul Sharma
Head & Neck.2017; 39(9): 1788. CrossRef
Silencing of FANCD2 enhances the radiosensitivity of metastatic cervical lymph node-derived head and neck squamous cell carcinoma HSC-4 cells
Hua-Jun Feng, Yi-Lin Bao, Zhuo-Ping Liang, Fei-Peng Zhao, Sheng-En Xu, Wei Xu, Chong Zhao, Gang Qin
International Journal of Oncology.2017; 50(4): 1241. CrossRef
Do circulating long non-coding RNAs (lncRNAs) (LincRNA-p21, GAS 5, HOTAIR) predict the treatment response in patients with head and neck cancer treated with chemoradiotherapy?
Merdan Fayda, Mustafa Isin, Makbule Tambas, Murat Guveli, Rasim Meral, Musa Altun, Dilek Sahin, Gozde Ozkan, Yasemin Sanli, Husniye Isin, Emre Ozgur, Ugur Gezer
Tumor Biology.2016; 37(3): 3969. CrossRef
Diagnostic and therapeutic features associated with modification of quality-of-life's outcomes between one and six months after major surgery for head and neck cancer
Margherita Gobbo, Federica Bullo, Giuseppe Perinetti, Annalisa Gatto, Giulia Ottaviani, Matteo Biasotto, Giancarlo Tirelli
Brazilian Journal of Otorhinolaryngology.2016; 82(5): 548. CrossRef
Recurrence patterns after postoperative radiotherapy for squamous cell carcinoma of the pharynx and larynx
Yusuke Iizuka, Michio Yoshimura, Haruo Inokuchi, Yukinori Matsuo, Akira Nakamura, Takashi Mizowaki, Shigeru Hirano, Morimasa Kitamura, Ichiro Tateya, Masahiro Hiraoka
Acta Oto-Laryngologica.2015; 135(1): 96. CrossRef
Chemotherapy of Head and Neck Cancer
Chang Ki Yeo
Korean Journal of Otorhinolaryngology-Head and Neck Surgery.2014; 57(5): 291. CrossRef
Photochemotherapeutic effects of UV-C on acridine orange in human breast cancer cells: potential application in anticancer therapy
Arunkumar Pitchaimani, Arun Renganathan, Selvamurugan Cinthaikinian, Kumpati Premkumar
RSC Advances.2014; 4(42): 22123. CrossRef
Analysis of the Prognostic Factors for Distant Metastasis after Induction Chemotherapy Followed by Concurrent Chemoradiotherapy for Head and Neck Cancer
Dong Hyun Kim, Won Taek Kim, Joo Hye Lee, Yong Kan Ki, Ji Ho Nam, Byung Joo Lee, Jin Choon Lee, Young Jin Choi, Young Mi Seol, Dong Won Kim
Cancer Research and Treatment.1970; 47(1): 46. CrossRef

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Treatment Outcome of Cisplatin-based Concurrent Chemoradiotherapy in the Patients with Locally Advanced Nasopharyngeal Cancer: Tae Hee Kim, Yoon Ho Ko, Myung Ah Lee, Bum-soo Kim, So Ryoung Chung, Ie Ryung Yoo, Chan-Kwon Jung, Yeon-Sil Kim, Min Sik Kim, Dong-Il Sun, Young Seon Hong, Kyung Shik Lee, Jin-Hyoung Kang; Cancer Res Treat. 2008;40(2):62-70. Published online June 30, 2008; DOI: https://doi.org/10.4143/crt.2008.40.2.62

Abstract PDF PubReader ePub

Purpose

The standard treatment of locally advanced nasopharyngeal cancer is a concurrent chemoradiotherapy (CCRT), and cisplatin has been used as the most popular chemotherapeutic agent. But many different doses and schedules for cisplatin administration such as daily, weekly and 3 week cycles have been proposed. We compared and analyzed the tumor response, the overall survival, the toxicity and the chemotherapy dose intensity in the patients with locally advanced nasopharyngeal cancer who were treated with CCRT.

Materials and Methods

We performed a retrospective study on 55 patients with locally advanced nasopharyngeal cancer, and they were treated with CCRT as a front-line treatment from Jan 1996 to Jun 2007 at Kangnam Saint Mary's Hospital.

Results

The patients had a median age of 53 years (range: 19~75 years). Of the total 55 patients, a 3-week cycle of 100mg cisplatin was administered in 31 patients and 30 mg weekly cisplatin was administered in 24 patients combined with radiotherapy. Twenty one patients had a complete response and four patients had a partial response for a response rate of 71.4% (95% CI: 59.5~83.3) after CCRT and followed by adjuvant chemotherapy. The complete response rates for the 30 mg and 100 mg cisplatin groups were 72.7% (95% CI: 54.9~90.5) and 54.2% (95% CI: 36.7~71.7), respectively (p=0.23). The duration of CCRT in the 100mg cisplatin group was significantly longer than that of the 30mg cisplatin group (11.1±2.9 weeks vs. 9.0±1.2 weeks, p=0.003). The major deviation group, which was defined as prolongation of the radiotherapy duration for more than 2 weeks, had a significantly lower objective response rate than did the non-deviation group (56.3% vs 84.2%, respectively, p=0.002). The major severe toxicities were leucopenia (49.1%), pharyngoesophagitis (49.1%), anorexia (43.6%), nausea (41.8%) and vomiting (40%).

Conclusions

Weekly 30mg cisplatin-based CCRT is a practical, feasible cisplatin schedule for the patients with locally advanced nasopharyngeal cancer in regard to decreasing the interruption of radiation treatment and decreasing the treatment-related acute toxicities.

Citations

Citations to this article as recorded by

A prognostic and predictive model based on deep learning to identify optimal candidates for intensity-modulated radiotherapy alone in patients with stage II nasopharyngeal carcinoma: A retrospective multicenter study
Jiong-Lin Liang, Yue-Feng Wen, Ying-Ping Huang, Jia Guo, Yun He, Hong-Wei Xing, Ling Guo, Hai-Qiang Mai, Qi Yang
Radiotherapy and Oncology.2025; 203: 110660. CrossRef
The Effect of Prolonged Duration of Intensity Modulated Radiotherapy for Nasopharyngeal Carcinoma
Yi-Jun Hua, Yan-Feng Ou-Yang, Xiong Zou, Le Xia, Dong-Hua Luo, Ming-Yuan Chen
Frontiers in Oncology.2021;[Epub] CrossRef
Taxane-based Induction Chemotherapy Plus Concurrent Chemoradiotherapy in Nasopharyngeal Carcinoma: Prospective Results from a Non-endemic Cohort
S. Ghosh-Laskar, A. Pilar, K. Prabhash, A. Joshi, J.P. Agarwal, T. Gupta, A. Budrukkar, V. Murthy, M. Swain, V. Noronha, V.M. Patil, P. Pai, D. Nair, D.A. Chaukar, S. Thiagarajan, G. Pantvaidya, A. Deshmukh, P. Chaturvedi, S. Nair, A. D‘Cruz
Clinical Oncology.2019; 31(12): 850. CrossRef
Long-term outcomes of concurrent chemoradiotherapy versus radiotherapy alone in stage II nasopharyngeal carcinoma treated with IMRT: a retrospective study
Zhen Su, Yan-Ping Mao, Jie Tang, Xiao-Wen Lan, Pu-Yun OuYang, Fang-Yun Xie
Tumor Biology.2016; 37(4): 4429. CrossRef
Concurrent chemoradiotherapy was associated with a higher severe late toxicity rate in nasopharyngeal carcinoma patients compared with radiotherapy alone: a meta-analysis based on randomized controlled trials
Cheng-run Du, Hong-mei Ying, Fang-fang Kong, Rui-ping Zhai, Chao-su Hu
Radiation Oncology.2015;[Epub] CrossRef
Concurrent Chemotherapy for T4 Classification Nasopharyngeal Carcinoma in the Era of Intensity-Modulated Radiotherapy
Cai-neng Cao, Jing-wei Luo, Li Gao, Jun-lin Yi, Xiao-dong Huang, Kai Wang, Shi-ping Zhang, Yuan Qu, Su-yan Li, Jian-ping Xiao, Zhong Zhang, Guo-zhen Xu, Riccardo Dolcetti
PLOS ONE.2015; 10(3): e0119101. CrossRef
Controversies in the systemic treatment of Nasopharyngeal carcinoma
Herbert H. Loong, Anthony T.C. Chan
Oral Oncology.2014; 50(9): 785. CrossRef
Intensity-modulated radiotherapy with simultaneous integrated boost for locoregionally advanced nasopharyngeal carcinoma
Junlin Yi, Xiaodong Huang, Li Gao, Jingwei Luo, Shiping Zhang, Kai Wang, Yuan Qu, Jianping Xiao, Guozhen Xu
Radiation Oncology.2014;[Epub] CrossRef
Factors Predict Prolonged Wait Time and Longer Duration of Radiotherapy in Patients with Nasopharyngeal Carcinoma: A Multilevel Analysis
Po-Chun Chen, Ching-Chieh Yang, Cheng-Jung Wu, Wen-Shan Liu, Wei-Lun Huang, Ching-Chih Lee, Bart O. Williams
PLoS ONE.2014; 9(10): e109930. CrossRef
Pretreatment Epstein-Barr Virus DNA Load and Cumulative Cisplatin Dose Intensity Affect Long-Term Outcome of Nasopharyngeal Carcinoma Treated with Concurrent Chemotherapy: Experience of an Institute in an Endemic Area
Weihong Wei, Zeli Huang, Shaoen Li, Hemei Chen, Guoyi Zhang, Shuxia Li, Weihan Hu, Tao Xu
Oncology Research and Treatment.2014; 37(3): 88. CrossRef
Concurrent Chemoradiotherapy vs Radiotherapy Alone in Stage II Nasopharyngeal Carcinoma: Phase III Randomized Trial
Qiu-Yan Chen, Yue-Feng Wen, Ling Guo, Huai Liu, Pei-Yu Huang, Hao-Yuan Mo, Ning-Wei Li, Yan-Qun Xiang, Dong-Hua Luo, Fang Qiu, Rui Sun, Man-Quan Deng, Ming-Yuan Chen, Yi-Jun Hua, Xiang Guo, Ka-Jia Cao, Ming-Huang Hong, Chao-Nan Qian, Hai-Qiang Mai
JNCI: Journal of the National Cancer Institute.2011; 103(23): 1761. CrossRef
Radiation Therapy Combined with (or without) Cisplatin-based Chemotherapy for Patients with Nasopharyngeal Cancer: 15-years Experience of a Single Institution in Korea
Yeon-Sil Kim, Bum-Soo Kim, So-Lyoung Jung, Yeon-Soo Lee, Min-Sik Kim, Dong-Il Sun, Eun-Jung Yoo, Seong-Kwon Mun, Sei-Chul Yoon, Su-Mi Chung, Hoon-Kyo Kim, Seung-Ho Jo, Jin-Hyoung Kang
Cancer Research and Treatment.2008; 40(4): 155. CrossRef

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c-myc Oncogens Amplification in Squamous Cell Cancer ( SCC ) of Head and Neck: Han Lim Moon, Chi Wha Han, Hoon Kyo Kim, Choon Choo Kim, Kyung Shik Lee, Dong Jip Kim, Min Sik Kim, Seung Ho Cho, Byung Do Suh; J Korean Cancer Assoc. 1990;22(1):32-37.

Abstract PDF: Proto-oncogenes are highly conservative genes in human cell, which code growth factors, growth factor receptors. enzymes and nuclear protein and are necessary for cell growth and function. Alteration in these genes such as amplification, rearrangement, or mutation appeared to be associated with malignant transfarmation of cells. We examined 14 DNA samples from human squamous cell carcinoma of head and neck with slot blot analysi.. Two out of fourteen samples showed c-myc gene amplification. Nodal involvements (N2a. and N3b) vrere observed in both patients. They were maderately differentiated SCC of larynx. Further studies about c-myc gene rearrangenment and mutaiton should be confirmeg in these samples and examine whether c-myc amplification is correlated with the biologic characteristics of SCC of head and neck.

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Treatment of Olfactory Neuroblastoma with Combination Chemotherapy and radiation Therapy: Jong Youl Jin, Choon Snag Bang, Hoon Kyo Kim, Kyung Shik Lee, Dong Jip Kim, Min Sik Kim, Seung Ho Cho, Byung Do Suh, Sei Chul Yoon, Kyu Ho Choi; J Korean Cancer Assoc. 1990;22(3):595-600.

Abstract PDF: Olfactory neuroblastoma (esthesioneuroblastoma) is very rare nasal tumor, which develops in the olfactory mucosa. Since the first description by Berger et al in 1924, about 200 cases have been reported in the literature. And there have been 3 reports since 1964 in Korea. All the reported cases in Korea were treated with surgical resection and or radiotherapy. The authors have experienced complete remission with combination chemotherapy and radiation therapy in a patient with olfactory neuroblastoma. A 55-year-old male presented with advanced unresectable olfactory neurobIastoma (stage C) and he was treated with combination chemotherapy (cisplatin, adriamycin, VM-26, cycloposphamide) every 3-4 weeks for 5 times followed by radition therapy (64BO cGy/36 fractions/9 weeks), which resulted in complete remission. The patient had been free of disease and asymptomatic for 8 months after treatment. Rescently left facial nerve palsy developed, of which etiology due to recurrence or treatment related fibrosis is unclear. Now, the authors are on study the etiology of left facial nerve palsy.

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Treatment Results of Radiation Therapy in Laryngeal Cancer: Hong Seok Jang, Sei Chul Yoon, Sei Chul Yoon, Ki Mun Kang, Chul Seung Kay, Min Sik Kim, Byung Do Suh, Hoon Kyo Kim, Kyung Shik Lee, Kyung Sub Shinn; J Korean Cancer Assoc. 1994;26(6):950-959.

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