Modified radical neck dissection and minimal invasive tumor surgery in the middle of split course of concomitant chemoradiotherapy of advanced HNSCC.
OBJECTIVE
The effectiveness of modified radical neck dissection with concomitant chemoradiotherapy in patients with N2/3 advanced head and neck cancer was evaluated.


METHODS
Retrospective study of 35 patients treated at the University Hospital, Medical University, Innsbruck. The treatment consisted of a split course radiation up to 70 Gy with concomitant chemotherapy with Mytomicin C and 5-fluorouracil. Neck dissection and/or tumor resection was performed between the two cycles of radiation and chemotherapy.


RESULTS
The 2-year progression-free survival was 64%, locoregional control 92% and overall survival 55. Observed toxicities included mucositis (grade 3, 35%; grade 4, 16%), neutropenia (grade 4, 28%), and thrombocytopenia (grade 4, 26%). No complications related to modified radical neck dissection were observed.


CONCLUSIONS
Intermittent neck dissection was highly effective in controlling the neck disease. Mitomycin C-based chemoradiotherapy for treatment of locally advanced cancer seems to be an option to cisplatin-based regimens.
Schwentner
Ilona
I
Department of Otorhinolaryngology, University Hospital, Medical University Innsbruck, Austria. Ilona.schwentner@uibk.ac.at
Schmutzhard
Joachim
J
Andrle
Jan
J
Haidenberger
Alfred
A
Thumfart
Walter F
WF
De Vries
Alexander
A
Sprinzl
Georg M
GM
D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000009:adverse effects / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000627:therapeutic use*; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D016685:Mitomycin / Q000009:adverse effects / Q000627:therapeutic use*; D037981:Neck Dissection / Q000379:methods; D009367:Neoplasm Staging; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012189:Retrospective Studies
D000903:Antibiotics, Antineoplastic; D016685:Mitomycin; D005472:Fluorouracil