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Selective organ preservation in operable locally advanced head and neck squamous cell carcinomas guided by primary site restaging biopsy: long-term results of two sequential brown university oncology group chemoradiotherapy studies.

Publication ,  Journal Article
Wanebo, HJ; Rathore, R; Chougule, P; DiSiena, MR; Koness, RJ; McRae, RG; Nigri, PT; Radie-Keane, K; Ready, N
Published in: Ann Surg Oncol
November 2011

OBJECTIVES: The long-term outcomes of selective organ preservation in operable, locally advanced head and neck cancers in two sequential chemoradiotherapy (CRT) protocols (HN-53, HN-67) are reported. METHODS: A total of 65 patients were treated with CRT consisting of carboplatin (AUC=1/week) and paclitaxel (60 or 40 mg/m2/week) with radiation (1.8 Gy/day). After 5 weeks of CRT, if primary site biopsies were pathologically negative, then completion CRT to 67-72 Gy was done with neck dissection in node-positive cases. Alternatively, a positive rebiopsy required primary site resection and neck dissection followed by radiotherapy boost as deemed necessary. RESULTS: Pathologic complete responses occurred in 71% patients who then completed CRT; the remaining 29% patients underwent primary site surgery. The 5-year and median overall survival were 47% and 57 months with no statistically significant differences between the two groups. Overall long-term failure rates were: 6% local, 6% regional, and 32% distant. CONCLUSIONS: This strategy of selective organ preservation was effective in 71% patients with CRT, whereas salvage surgery was required in the remainder. Long-term survival was equivalent in both treatment groups.

Duke Scholars

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

November 2011

Volume

18

Issue

12

Start / End Page

3479 / 3485

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Remission Induction
  • Paclitaxel
  • Organ Preservation
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Neck Dissection
  • Middle Aged
 

Citation

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MLA
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Wanebo, H. J., Rathore, R., Chougule, P., DiSiena, M. R., Koness, R. J., McRae, R. G., … Ready, N. (2011). Selective organ preservation in operable locally advanced head and neck squamous cell carcinomas guided by primary site restaging biopsy: long-term results of two sequential brown university oncology group chemoradiotherapy studies. Ann Surg Oncol, 18(12), 3479–3485. https://doi.org/10.1245/s10434-011-1697-0
Wanebo, Harold J., Ritesh Rathore, Prakash Chougule, Michael R. DiSiena, R James Koness, Robert G. McRae, Peter T. Nigri, Kathy Radie-Keane, and Neal Ready. “Selective organ preservation in operable locally advanced head and neck squamous cell carcinomas guided by primary site restaging biopsy: long-term results of two sequential brown university oncology group chemoradiotherapy studies.Ann Surg Oncol 18, no. 12 (November 2011): 3479–85. https://doi.org/10.1245/s10434-011-1697-0.
Journal cover image

Published In

Ann Surg Oncol

DOI

EISSN

1534-4681

Publication Date

November 2011

Volume

18

Issue

12

Start / End Page

3479 / 3485

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Survival Rate
  • Remission Induction
  • Paclitaxel
  • Organ Preservation
  • Oncology & Carcinogenesis
  • Neoplasm Staging
  • Neoplasm Recurrence, Local
  • Neck Dissection
  • Middle Aged