gms | German Medical Science

27. Deutscher Krebskongress

Deutsche Krebsgesellschaft e. V.

22. - 26.03.2006, Berlin

Results of primary IMRT Radio- and Radio-Chemotherapy in inoperable head and neck cancer patients

Meeting Abstract

  • corresponding author presenting/speaker Andre Buchali - Klinik für Radioonkologie, Ruppiner Kliniken GmbH, Neuruppin, Deutschland
  • Eyck Blank - Klinik für Radioonkologie, Ruppiner Kliniken GmbH, Neuruppin
  • Achim Franzen - HNO Klinik, Ruppiner Kliniken GmbH, Neuruppin
  • Gerhard Keune - HNO Klinik, Oberhavelkliniken GmbH, Hennigsdorf
  • Michael Schmidt - Klinik für Radioonkologie, Ruppiner Kliniken GmbH, Neuruppin
  • Winfried Huhnt - Klinik für Radioonkologie, Ruppiner Kliniken GmbH, Neuruppin
  • Dietrich Sidow - Klinik für Radioonkologie, Ruppiner Kliniken GmbH, Neuruppin

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO247

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Veröffentlicht: 20. März 2006

© 2006 Buchali et al.
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Aim: Evaluation of the locoregional control of patients with inoperable head and neck cancer after definitive IMRT radiotherapy with simultaneous chemotherapy.

Material and methods: From Oct. 2002 to Nov. 2005, 59 patients with inoperable head and neck carcinoma were treated. 42 pts received simultaneous chemotherapy with CDDP/CBDCA and 5FU. 17 pts were treated with radiotherapy exclusively. The total dose amounted to 72 Gy for the macroscopic tumour and lymph nodes, 64 Gy for the first non macroscopic lymph node level and 56 Gy for the second lymph node level, all included in a single IMRT plan. The single dose was 2 Gy for the macroscopic tumor. The pts were treated 6 times per week giving a total period of 6 weeks. 6 out of 59 patients had distant metastases initially.

Results: The radiotherapy could be finished in 56 pts, 3 pts died during radiotherapy from myocardial infarction (n=2) and lethal tumour bleeding (n=1). Simultaneous chemotherapy was interrupted for hematotoxicity in 8 pts, for nephrotoxicity in 3, due to progression of distant metastases in 5, due to excessive alcohol consumption in 2, and for intercurrent disease in 2 pts. 22 pts (52%) completed their simultaneous chemotherapy course. After a median follow up of 41 weeks 29 pts are alive with a complete locoregional response (CR) (24), with a good partial response (PR) without progression (2), with isolated local recurrence (1), with distant metastasis without local recurrence (1), and with CR and a second malignancy (1). 18 pts died, 2 from local recurrence, 12 from distant metastases despite locoregional control (7 CR, 5 PR without progression) and 4 from intercurrent disease without tumour signs. Locoregional control was achieved in 44/50 pts (88%): 74% CR, 14% PR without locoregional failure. 8/37 pts (22%) with CR, and 5/7 pts (71%) with PR without progression developed distant metastases.

Conclusions: The higher conformal dose distribution by IMRT RT does not increase local failure rates. In contrary, the improved homogeneity of its dose distribution increases locoregional control rates compared to conformal 3D techniques. Despite this high rate of local control survival numbers are limited by a high quantity of distant metastases, and the considerable comorbidity of these patients.