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Published on: April 22, 2019
Early morbidity after radiotherapy with or without chemotherapy in advanced head and neck cancer. Experience from
Sabine Bieri1, Soeren M Bentzen, Pia Huguenin
1Department of Radiation Oncology, Regional Hospital of Sion, Switzerland. sabine.bieri@chr.ch
Background:
Data on early treatment-related morbidity after radiotherapy alone (RT; 217 patients) or combined with chemotherapy (RT + CT; 182 patients) of head and neck squamous cell carcinoma are analyzed.
Patients And Methods:
The patients were treated between November 1985 and November 1996 in four Swiss centers that independently introduced combined-modality therapy in selected cases of head and neck cancer. RT schedules varied among the four centers, but within each institution all patients received the same dose-fractionation schedule irrespective of whether they had CT or not. The following early morbidity items were evaluated: skin, mucosa, larynx, salivary glands, dysphagia, weight loss, and toxic death. Toxicity was scored using the EORTC/RTOG scale.
Results:
Although considerable variation was noted among the treatment schedules/centers, the main findings are as follows: (1) early morbidity was significantly enhanced after all five RT + CT schedules compared with RT alone; (2) typically, a third of the patients lost > 10% of their body weight during concurrent RT + CT as compared with 10% of the patients receiving RT alone; (3) at 12 weeks, the prevalence of grade 2 morbidity was 25-60% after RT + CT as compared with 4-20% after RT alone.
Conclusion:
A number of early morbidity items were found to be more prevalent and/or more severe after RT + CT than after RT alone.
