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Strahlentherapie und Onkologie

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01-01-2012 | Original article

Survival of patients with head and neck cancer

Impact of physical status and comorbidities

Authors: F. Sadat, A. Wienke, J. Dunst, T. Kuhnt, MD

Published in: Strahlentherapie und Onkologie | Issue 1/2012

Abstract

Background

Prognostic factors (e.g., gender, tumor stage, and hypoxia) have an impact on survival in patients with head and neck cancer. Thus, the impact of physical status and comorbidities on treatment decision and survival were evaluated.

Patients and methods

A total of 169 primary, inoperable patients with squamous cell cancer of the head and neck were retrospectively investigated. Patients were treated with hyperfractionated accelerated radio(chemo)therapy (HARcT) or hypofractionated radio(chemo)therapy (HypoRcT). Depending on the individual patient’s situation (Karnofsky Performance Index, KPI), treatment for patients with a KPI of 80–100% was generally radiochemotherapy and for patients with a KPI ≤ 70% treatment was radiotherapy alone. In addition, all comorbidities were evaluated. Uni- and multivariate proportional hazards model were used, and overall survival (OS) was estimated by the Kaplan–Meier method.

Results

Treatment consisted of HARcT for 76 patients (45%), HART for 28 patients (17%), HypoRcT for 14 patients(8%), and HypoRT for 51 patients (30%). Of the patients, 107 patients (63%) presented with a KPI of 80–100%. OS (20%) was significantly better for patients with a KPI of 80–100%, while the OS for patients with a KPI ≤ 70% was 8% (p < 0.001). Good KPI, total irradiation dose (> 70 Gy), and chemotherapy were significant prognostic factors for better OS.

Conclusion

Our retrospective analysis shows that performance status with dependency on comorbidities was an independent risk factor for OS.

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Title: Survival of patients with head and neck cancer
Impact of physical status and comorbidities
Authors: F. Sadat
A. Wienke
J. Dunst
T. Kuhnt, MD
Publication date: 01-01-2012
Publisher: Urban and Vogel
Published in: Strahlentherapie und Onkologie / Issue 1/2012
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-011-0009-8

At a glance: The STEP trials

Springer Medicine

Survival of patients with head and neck cancer

Impact of physical status and comorbidities

Abstract

Background

Patients and methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Patients and methods

Results

Conclusion

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