Original Article

Increased local failure risk with prolonged radiation treatment time in head and neck cancer treated with concurrent chemotherapy

  1. Donald M. Cannon MD1,*,
  2. Heather M. Geye MS1,2,
  3. Gregory K. Hartig MD2,
  4. Anne M. Traynor MD3,
  5. Tien Hoang MD3,
  6. Timothy M. McCulloch MD2,
  7. Peggy A. Wiederholt RN1,
  8. Richard J. Chappell PhD4 and
  9. Paul M. Harari MD1

Version of Record online: 27 NOV 2013

DOI: 10.1002/hed.23419

Issue

Head & Neck

Head & Neck

Volume 36, Issue 8, pages 1120–1125, August 2014


Additional Information

How to Cite

Cannon, D. M., Geye, H. M., Hartig, G. K., Traynor, A. M., Hoang, T., McCulloch, T. M., Wiederholt, P. A., Chappell, R. J. and Harari, P. M. (2014), Increased local failure risk with prolonged radiation treatment time in head and neck cancer treated with concurrent chemotherapy. Head Neck, 36: 1120–1125. doi: 10.1002/hed.23419

Author Information

  1. 1

    Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

  2. 2

    Department of Surgery – Otolaryngology, Head and Neck Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

  3. 3

    Department of Medicine – Medical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

  4. 4

    Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin

*Corresponding author: D. M. Cannon, Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, 600 Highland Ave K4/B100, Madison, WI 53792. E-mail: dcannon@humonc.wisc.edu

  1. This work was presented in part at the American Society for Radiation Oncology (ASTRO) 53rd Annual Meeting in Miami, Florida, October 2011.

Publication History

  1. Issue online: 11 JUL 2014
  2. Version of Record online: 27 NOV 2013
  3. Accepted manuscript online: 26 JUN 2013 12:00AM EST
  4. Manuscript Accepted: 10 JUN 2013
  5. Manuscript Revised: 1 MAR 2013
  6. Manuscript Received: 9 NOV 2012

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Keywords:

  • head and neck cancer;
  • chemoradiotherapy;
  • accelerated repopulation;
  • treatment time;
  • prognostic factors

Abstract

Background

Prolonged radiation treatment time (RTT) in head and neck squamous cell carcinoma (HNSCC) is associated with inferior tumor control in patients treated with radiation therapy (RT) alone. However, the significance of prolonged RTT with concurrent chemotherapy is less clear.

Methods

We reviewed outcomes for 171 patients with primary HNSCC treated with curative intent RT and concurrent drug therapy from 2001 to 2009. The effects of RTT and other variables on local control and survival were analyzed.

Results

Patients with RTT >7 weeks had a significantly increased risk of local failure (hazard ratio [HR], 2.6; p = .018) and death (HR, 1.9 p = .035). These results retained significance even after adjustment for tumor stage (age was not significant).

Conclusion

For patients treated with concurrent chemoradiotherapy (chemoRT), prolonged RTT may compromise tumor control as has been established in the setting of RT alone. Symptoms of patients with HNSCC undergoing definitive chemoRT should be managed aggressively to limit treatment interruptions. © 2013 Wiley Periodicals, Inc. Head Neck 36: 1120–1125, 2014

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