Modified radical neck dissection and minimal invasive tumor surgery in the middle of split course of concomitant chemoradiotherapy of advanced HNSCC

Auris Nasus Larynx. 2007 Mar;34(1):85-9. doi: 10.1016/j.anl.2006.09.016. Epub 2006 Oct 30.

Abstract

Objective: The effectiveness of modified radical neck dissection with concomitant chemoradiotherapy in patients with N2/3 advanced head and neck cancer was evaluated.

Study design and setting: Retrospective study of 35 patients treated at the University Hospital, Medical University, Innsbruck. The treatment consisted of a split course radiation up to 70 Gy with concomitant chemotherapy with Mytomicin C and 5-fluorouracil. Neck dissection and/or tumor resection was performed between the two cycles of radiation and chemotherapy.

Results: The 2-year progression-free survival was 64%, locoregional control 92% and overall survival 55. Observed toxicities included mucositis (grade 3, 35%; grade 4, 16%), neutropenia (grade 4, 28%), and thrombocytopenia (grade 4, 26%). No complications related to modified radical neck dissection were observed.

Conclusion: Intermittent neck dissection was highly effective in controlling the neck disease. Mitomycin C-based chemoradiotherapy for treatment of locally advanced cancer seems to be an option to cisplatin-based regimens.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibiotics, Antineoplastic / adverse effects
  • Antibiotics, Antineoplastic / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols
  • Carcinoma, Squamous Cell* / drug therapy
  • Carcinoma, Squamous Cell* / radiotherapy
  • Carcinoma, Squamous Cell* / surgery
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Fluorouracil / adverse effects
  • Fluorouracil / therapeutic use*
  • Head and Neck Neoplasms* / drug therapy
  • Head and Neck Neoplasms* / radiotherapy
  • Head and Neck Neoplasms* / surgery
  • Humans
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods*
  • Mitomycin / adverse effects
  • Mitomycin / therapeutic use*
  • Neck Dissection / methods
  • Neoplasm Staging
  • Radiotherapy / adverse effects
  • Radiotherapy Dosage
  • Retrospective Studies

Substances

  • Antibiotics, Antineoplastic
  • Mitomycin
  • Fluorouracil