Original scientific paper
Altered fractionation regimens in primary radiotherapy for squamous cell carcinoma of larynx, oropharynx and hypopharynx – an analysis of prognostic factors for locoregional control and survival
Valentina Krstevska
; Institute of Radiotherapy and Oncology, Clinical Center, Skopje, R. Macedonia
Snezhana Smichkoska
; Institute of Radiotherapy and Oncology, Clinical Center, Skopje, R. Macedonia
Simonida Crvenkova
; Institute of Radiotherapy and Oncology, Clinical Center, Skopje, R. Macedonia
Abstract
Detailed evaluation of the most important factors influencing prognosis was one of the objectives of our randomized study comparing altered fractionation schedules with conventional fractionation in primary definitive radiotherapy for squamous cell carcinomas of the larynx, oropharynx and hypopharynx. Conventional fractionation (66 to 70 Gy, 2 Gy per fraction, 5 fractions per week) was performed in 51 of 152 (33.5%) patients, hyperfractionation (74.4 to 79.2 Gy, two fractions of 1.2 Gy per day, 10 fractions per week) in 50 (33.0%) patients, and accelerated fractionation (54 Gy, 1.8 Gy dose per fraction, 5 fractions per week in the basic course and concomitant boost with 1.5 Gy per fraction as a second daily fraction during the last 10 to 12 days) was used in 51 (33.5%) patients. The univariate analysis of six clinical prognostic factors and one histological prognostic factor allowed us to identify the age, Karnofsky index, tumor size (T stage), nodal involvement (N stage), tumor site, and degree of histological differentiation as strongly associated with prognosis. A multivariate analysis was carried out and the size of the tumor (T stage) and the nodal involvement (N stage) were found as two independent variables significantly influencing locoregional control (p < 0.0008; 2 = 11.26 and p < 0.00001; 2 = 19.58, respectively). T stage and N stage were also found to be the significant independent prognostic factors for survival (p < 0.0007; 2 = 11.53 and p < 0.00001; 2 = 33.26, respectively).
Keywords
altered fractionation; prognostic factor; head and neck cancer
Hrčak ID:
281569
URI
Publication date:
20.12.2004.
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