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- Title
Long-term functional and survival outcomes after induction chemotherapy and risk-based definitive therapy for locally advanced squamous cell carcinoma of the head and neck.
- Authors
Hutcheson, Katherine A.; Lewin, Jan S.; Holsinger, F. Christopher; Steinhaus, Ganene; Lisec, Asher; Barringer, Denise A.; Lin, Heather Y.; Villalobos, Sandra; Garden, Adam S.; Papadimitrakopoulou, Vali; Kies, Merrill S.
- Abstract
Background The purpose of this study was to evaluate long-term outcomes after induction chemotherapy followed by 'risk-based' local therapy for locally-advanced squamous cell carcinoma of the head and neck (SCCHN). Methods Forty-seven patients (stage IV; ≥N2b) were enrolled in a phase II trial. Baseline and 24-month functional measures included modified barium swallow (MBS) studies, oropharyngeal swallow efficiency (OPSE), and the MD Anderson Dysphagia Inventory (MDADI). Functional status was assessed at 5 years. Results Five-year overall survival (OS) was 89% (95% confidence interval [CI], 81% to 99%). A nonsignificant 13% average reduction in swallowing efficiency (OPSE) was observed at 24 months relative to baseline ( p = .191). MDADI scores approximated baseline at 24 months. Among 42 long-term survivors (median, 5.9 years), 3 patients (7.1%) had chronic dysphagia. The rate of final gastrostomy dependence was 4.8% (2 of 42). Conclusion Sequential chemoradiotherapy achieved favorable outcomes among patients with locally advanced SCCHN, mainly of oropharyngeal origin. MBS and MDADI scores found modest swallowing deterioration at 2 years, and chronic aspiration was uncommon in long-term survivors. © 2013 Wiley Periodicals, Inc. Head Neck 36: 474-480, 2014
- Subjects
DEGLUTITION; CANCER chemotherapy; CANCER patients; SQUAMOUS cell carcinoma; GASTROSTOMY
- Publication
Head & Neck, 2014, Vol 36, Issue 4, p474
- ISSN
1043-3074
- Publication type
Article
- DOI
10.1002/hed.23330