title: Treatment results and prognostic factors for advanced squamous cell carcinoma of the head and neck treated with concurrent chemoradiotherapy.
abstract: OBJECTIVE
  To review our experience in the treatment of concurrent chemoradiotherapy (CCR) for patients with advanced squamous cell carcinoma of the head and neck (SCCHN) and to evaluate the different factors affecting survival and primary organ preservation.
  
  
  METHODS
  We reviewed the records of 101 patients with SCCHN treated with CCR between February 1998 and April 2004. Of 101 patients, 76 were treated with a cisplatin, 5-fluorouracil, methotrexate, and leucovorin (PFML) regimen and 25 were treated with a carboplatin and uracil-tegafur (CBDCA-UFT) regimen. Overall survival (OS), disease-specific survival (DSS) and DSS with primary organ preservation were estimated using Kaplan-Meier methods. The log-rank test and Cox proportional hazards regression were employed to identify significant prognostic factors for OS, DSS, and DSS with primary organ preservation.
  
  
  RESULTS
  The 5-year OS and DSS for all patients were 51.6 and 67.4%, respectively. On multivariate analysis, resectability of the tumor and degree of histological differentiation were significant predictors of survival for patients undergoing CCR; T stage and differentiation were significant prognostic factors for primary organ preservation.
  
  
  CONCLUSIONS
  In the treatment of CCR for advanced SCCHN, the survival rate of the patients with resectable tumors was excellent and significantly greater compared with the patients with unresectable tumors. T1 to T3 disease in patients with advanced resectable SCCHN is a good predictor of organ preservation. CCR may improve not only primary organ preservation (local control) but also survival in patients with poorly differentiated tumors.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, Yokohama City University School of Medicine, Kanazawa-ku, Japan. ttaguchi@yokohama-cu.ac.jp
authors.forename: Takahide
authors.initials: T
authors.lastname: Taguchi
authors.forename: Mamoru
authors.initials: M
authors.lastname: Tsukuda
authors.forename: Yasukazu
authors.initials: Y
authors.lastname: Mikami
authors.forename: Hideki
authors.initials: H
authors.lastname: Matsuda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Tanigaki
authors.forename: Choichi
authors.initials: C
authors.lastname: Horiuchi
authors.forename: Goshi
authors.initials: G
authors.lastname: Nishimura
authors.forename: Jun-ichi
authors.initials: J
authors.lastname: Nagao
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010039:Otorhinolaryngologic Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000532:radiotherapy*; D011379:Prognosis