Chemoradiotherapy for unresectable stage IVB head and neck cancer.
OBJECTIVE
As the occurrence of unresectable stage IVB head and neck cancer is expected to continue, we present our experience over the last 17 years with chemoradiotherapy management of 14 cases to clarify the effectiveness and safety of this treatment scheme.


METHODS
Of the 1,267 individuals who were diagnosed with carcinoma of the upper aerodigestive tract between 1992 to 2008, 14 patients were treated by induction chemotherapy followed by concurrent chemoradiation or simultaneous chemoradiotherapy for stage IVB disease. The median follow-up time was 54.5 months.


RESULTS
The complete objective response rate was 79%. Six individuals remained disease-free during a followup period ranging from 24 to 149 months. The disease-free survival rate at five years was 68%. Local, regional, and distant failure rates were 21%,14%, and 7% respectively. Most of the patients (79%) experienced transient mucositis during treatment. Significant late complications consisted of dental caries or osteoradionecrosis (14%) and esophageal stricture (7%).


CONCLUSIONS
Definitive chemoradiotherapy administered for unresectable stage IVB head and neck cancer has the potential of achieving long-term disease-free survival in up to two-thirds of the patients with a low risk of complications.
Division of Therapeutic Radiology, Louisiana State University Health Sciences Center, Shreveport, USA.
Federico
F
Ampil
Gloria
G
Caldito
Glenn
G
Mills
Amol
A
Takalkar
Ghali
G
Ghali
David
D
Kim
D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols; D059248:Chemoradiotherapy / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000532:radiotherapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D012074:Remission Induction; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome