TY - JOUR
T1 - Factors Predictive of Local Disease Control after Intra-arterial Concomitant Chemoradiation (RADPLAT)
AU - Robbins, K. Thomas
AU - Doweck, Ilana
AU - Samant, Sandeep
AU - Vieira, Francisco
AU - Kumar, Parvesh
PY - 2004/3/1
Y1 - 2004/3/1
N2 - Objectives: To determine the relative risk of prognostic factors for local disease control following RADPLAT. Study Design: Prospective study, academic medical center. Methods: Analyses of nine categories of risk factors among 240 patients with Stage II-IV carcinoma consecutively treated with RADPLAT (cisplatin 150 mg/m2 IA and sodium thiosulfate 9 g/m2 IV, weekly ×4; radiotherapy 2 Gy/fraction/d, 5× weekly, 68-74 Gy over 6 to 7 weeks). Median follow-up: 58 months (range, 12-96 mo). Results: The percentage of patients who had local disease control was 87.5%. Univariant analysis showed T classification (P = .01), laterality of neck disease (P = .026), number of neck levels involved (P = .008), total dose of radiation greater versus less than 60 Gy (P = .027), and presence of pathologically positive lymph nodes following chemoradiation (P = .01) to be significant. Logistic regression analysis showed total dose of radiation (P = .03) and the presence of pathologically positive lymph nodes following chemoradiation (P = .05) to be significant. For Kaplan-Meier estimates of local disease control at 5 years, T classification (P = .038), number of levels with nodal disease (P = .006), and total dose of radiation therapy (P = .0001) were significant. The log-rank test identified as significant the total dose of radiation therapy (P < .0001), the presence of pathologically positive lymph nodes following chemoradiation (P = .005), and the number of neck levels with positive nodes (P = .006). The Cox regression model showed significance for the total dose of radiation (P = .001), the presence of pathologically positive lymph nodes following chemoradiation (P = .007), and the T classification (P = .029). Conclusion: Risk factors significantly associated with local disease control after RADPLAT appears to differ from more traditional therapy and is suggestive of a paradigm shift.
AB - Objectives: To determine the relative risk of prognostic factors for local disease control following RADPLAT. Study Design: Prospective study, academic medical center. Methods: Analyses of nine categories of risk factors among 240 patients with Stage II-IV carcinoma consecutively treated with RADPLAT (cisplatin 150 mg/m2 IA and sodium thiosulfate 9 g/m2 IV, weekly ×4; radiotherapy 2 Gy/fraction/d, 5× weekly, 68-74 Gy over 6 to 7 weeks). Median follow-up: 58 months (range, 12-96 mo). Results: The percentage of patients who had local disease control was 87.5%. Univariant analysis showed T classification (P = .01), laterality of neck disease (P = .026), number of neck levels involved (P = .008), total dose of radiation greater versus less than 60 Gy (P = .027), and presence of pathologically positive lymph nodes following chemoradiation (P = .01) to be significant. Logistic regression analysis showed total dose of radiation (P = .03) and the presence of pathologically positive lymph nodes following chemoradiation (P = .05) to be significant. For Kaplan-Meier estimates of local disease control at 5 years, T classification (P = .038), number of levels with nodal disease (P = .006), and total dose of radiation therapy (P = .0001) were significant. The log-rank test identified as significant the total dose of radiation therapy (P < .0001), the presence of pathologically positive lymph nodes following chemoradiation (P = .005), and the number of neck levels with positive nodes (P = .006). The Cox regression model showed significance for the total dose of radiation (P = .001), the presence of pathologically positive lymph nodes following chemoradiation (P = .007), and the T classification (P = .029). Conclusion: Risk factors significantly associated with local disease control after RADPLAT appears to differ from more traditional therapy and is suggestive of a paradigm shift.
KW - Concomitant chemoradiation
KW - Head and neck cancer
KW - Local disease control
KW - RADPLAT
KW - Risk factors
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U2 - 10.1097/00005537-200403000-00004
DO - 10.1097/00005537-200403000-00004
M3 - Article
C2 - 15091211
AN - SCOPUS:1642348208
VL - 114
SP - 411
EP - 417
JO - Laryngoscope
JF - Laryngoscope
SN - 0023-852X
IS - 3
ER -