title: Disease control and functional outcome in three modern combined organ preserving regimens for locally advanced squamous cell carcinoma of the head and neck (SCCHN).
abstract: OBJECTIVE
  To report our experience on disease control and functional outcome using three modern combined-modality approaches for definitive radiochemotherapy of locally advanced SCCHN with modern radiotherapy techniques: radiochemotherapy (RChT), radioimmunotherapy (RIT) with cetuximab, or induction chemotherapy with docetaxel, cisplatin, and 5-FU (TPF) combined with either RChT or RIT.
  
  
  METHODS
  Toxicity and outcome was retrospectively analysed in patients receiving definitive RChT, RIT, or induction chemotherapy followed by RChT or RIT between 2006 and 2009. Outcome was estimated using Kaplan-Meier analyses, toxicity was analysed according to CTCAE v 3.0.
  
  
  RESULTS
  Thirty-eight patients were treated with RChT, 38 patients with RIT, 16 patients received TPF followed by either RChT or RIT. Radiotherapy was mostly applied as IMRT (68%). Long-term toxicity was low, only one case of grad III dysphagia requiring oesophageal dilatation, no case of either xerostomia ≥ grade II or cervical plexopathy were observed. Median overall survival (OS) was 25.7 months (RChT) and 27.7 months (RIT), median locoregional progression-free survival (PFS) was not reached yet. Subgroup analysis showed no significant differences between TPF, RChT, and RIT despite higher age and co-morbidities in the RIT group. Results suggested improved OS, distant and overall PFS for the TPF regimen.
  
  
  CONCLUSIONS
  Late radiation effects in our cohort are rare. No significant differences in outcome between RChT and RIT were observed. Adding TPF suggests improved progression-free and overall survival, impact of TPF on locoregional PFS was marginal, therefore radiotherapeutic options for intensification of local treatment should be explored.
authors.affiliation: Dept of Radiation Oncology, INF 400, 69120 Heidelberg, Germany. Alexandra.jensen@med.uni-heidelberg.de
authors.forename: Alexandra D
authors.initials: AD
authors.lastname: Jensen
authors.forename: Jürgen
authors.initials: J
authors.lastname: Krauss
authors.forename: Wilko
authors.initials: W
authors.lastname: Weichert
authors.forename: Zazie P
authors.initials: ZP
authors.lastname: Bergmann
authors.forename: Kolja
authors.initials: K
authors.lastname: Freier
authors.forename: Jürgen
authors.initials: J
authors.lastname: Debus
authors.forename: Marc W
authors.initials: MW
authors.lastname: Münter
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D016190:Carboplatin / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D000068818:Cetuximab; D059248:Chemoradiotherapy / Q000379:methods; D002945:Cisplatin / Q000008:administration & dosage; D015331:Cohort Studies; D000077143:Docetaxel; D005472:Fluorouracil / Q000494:pharmacology; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D016499:Radioimmunotherapy / Q000379:methods; D011878:Radiotherapy / Q000379:methods; D012189:Retrospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D043823:Taxoids / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D043823:Taxoids; D000077143:Docetaxel; D016190:Carboplatin; D000068818:Cetuximab; D002945:Cisplatin; D005472:Fluorouracil