Impact of tumor board recommendations on treatment outcome for locally advanced head and neck cancer.
OBJECTIVE
To identify physician selection factors in the treatment of locally advanced head and neck cancer and how treatment outcome is affected by Tumor Board recommendations.


METHODS
A retrospective analysis of 213 patients treated for locally advanced head and neck cancer in a single institution was performed. All treatments followed Tumor Board recommendations: 115 patients had chemotherapy and radiation, and 98 patients received postoperative radiation. Patient characteristics, treatment toxicity, locoregional control and survival between these two treatment groups were compared. Patient survival was compared with survival data reported in randomized studies of locally advanced head and neck cancer.


RESULTS
There were no differences in comorbidity factors, and T or N stages between the two groups. A statistically significant number of patients with oropharyngeal and oral cavity tumors had chemoradiation and postoperative radiation, respectively (p < 0.0001). Grade 3-4 toxicities during treatment were 48 and 87% for the postoperative radiation and chemoradiation groups, respectively (p = 0.0001). There were no differences in survival, locoregional recurrences and distant metastases between the two groups. Patient survival was comparable to survival rates reported by randomized studies of locally advanced head and neck cancer.


CONCLUSIONS
Disease sites remained the key determining factor for treatment selection. Multidisciplinary approaches provided optimal treatment outcome for locally advanced head and neck cancer, with overall survival in these patients being comparable to that reported in randomized clinical trials.
Nguyen
Nam P
NP
Department of Radiation Oncology, University of Arizona, Tucson, Arizona 85724-5081, USA. NamPhong.Nguyen@yahoo.com
Vos
Paul
P
Lee
Howard
H
Borok
Thomas L
TL
Karlsson
Ulf
U
Martinez
Tomas
T
Welsh
James
J
Cohen
Deirdre
D
Hamilton
Russell
R
Nguyen
Nga
N
Nguyen
Ly M
LM
Vinh-Hung
Vincent
V
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D002945:Cisplatin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D019983:Guideline Adherence; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D006801:Humans; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery / Q000628:therapy*; D009367:Neoplasm Staging; D016522:Oncology Service, Hospital / Q000592:standards*; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D000970:Antineoplastic Agents; D002945:Cisplatin