RADIOCHEMOTHERAPY FOR ADVANCED HEAD AND NECK CARCINOMA – LJUBLJANA EXPERIENCE

  • Lojze Šmid University Department of Otorhinolaryngology and Cervicofacial Surgery Zaloška 2 1525 Ljubljana
  • Erika Šoba Institute of Oncology Zaloška 2 1525 Ljubljana
  • Marjan Budihna Institute of Oncology Zaloška 2 1525 Ljubljana
  • Branko Zakotnik Institute of Oncology Zaloška 2 1525 Ljubljana
  • Hotimir Lešničar Institute of Oncology Zaloška 2 1525 Ljubljana
  • Primož Strojan Institute of Oncology Zaloška 2 1525 Ljubljana
  • Miha Žargi University Department of Otorhinolaryngology and Cervicofacial Surgery Zaloška 2 1525 Ljubljana
  • Igor Fajdiga University Department of Otorhinolaryngology and Cervicofacial Surgery Zaloška 2 1525 Ljubljana
Keywords: carcinoma, radiotherapy, chemotherapy, surgery, head and neck

Abstract

In prospectively designed randomized clinical trial the efficacy of simultaneous application of irradiation, Mitomycin C, and Bleomycin was tested. 64 patients with previously untreated, histologically confirmed inoperable squamous cell carcinoma of the head and neck region were randomly assigned to receive either radiation therapy alone (group A) or radiotherapy combined with simultaneous application of Mitomycin C and Bleomycin (group B). In patients with inoperable oropharyngeal carcinoma, the disease free survival was significantly better in combined radiochemotherapy group (48%) then in only irradiated patients (10%) (p = 0.001).

The same combination was later tested in 114 patients with advanced but still resectable disease in the head and neck region as postoperative treatment. In prospective randomized clinical study, patients were treated postoperatively by irradiation alone (group A), or received postoperatively also concomitant chemotherapy (group B). At four years1, in patients from radiochemotherapy group, locoregional control (86%) was significantly better than in radiotherapy group (57%) (p = 0.037). Also, the overall survival for radiochemotherapy group was significantly better than for radiotherapy group (71% and 43% respectively) (p = 0.036). From the subgroup analysis, it seems that the patients who benefited by chemotherapy were those with high risk factors.

Proposed combined treatment scheme became in Slovenia the therapy of choice for patients with inoperable oropharyngeal carcinoma as well as for patients operated for advanced but still resectable head and neck carcinoma with one or more high risk factors.

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How to Cite
1.
Šmid L, Šoba E, Budihna M, Zakotnik B, Lešničar H, Strojan P, Žargi M, Fajdiga I. RADIOCHEMOTHERAPY FOR ADVANCED HEAD AND NECK CARCINOMA – LJUBLJANA EXPERIENCE. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];71. Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/1773
Issue
Vol 71 (2002): Supplement 3
Section
Original article


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