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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2011

01-11-2011 | Head and Neck Oncology

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

Authors: Harold J. Wanebo, MD, Ritesh Rathore, MD, Prakash Chougule, MD, Michael R. DiSiena, MD, R. James Koness, MD, Robert G. McRae, MD, Peter T. Nigri, MD, Kathy Radie-Keane, MD, Neal Ready, MD

Published in: Annals of Surgical Oncology | Issue 12/2011

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Abstract

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.
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Metadata
Title
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
Authors
Harold J. Wanebo, MD
Ritesh Rathore, MD
Prakash Chougule, MD
Michael R. DiSiena, MD
R. James Koness, MD
Robert G. McRae, MD
Peter T. Nigri, MD
Kathy Radie-Keane, MD
Neal Ready, MD
Publication date
01-11-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 12/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-011-1697-0

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