Medina GY, González FM, Rodríguez MJ, Ropero TR

Language: Spanish
References: 19
Page: 238-246
PDF size: 671.08 Kb.

ABSTRACT

Background: old people with advanced head and neck cancer have a pessimistic attitude to the radiant treatment because of the caused acute toxicity that can compromise the therapeutic results.
Objective: to characterize elderly patients with the diagnosis of head and neck locally advanced squamate carcinoma, proposed to receive radiation therapy in the analyzed period according to medical criteria.
Methods: a descriptive, retrospective study was conducted in the National Institute of Oncology and Radiobiology. The study included all the patients with the diagnosis of locally advanced head and neck squamate carcinoma, stages III-IV A and IV B (anatomical sites: oral cavity, oropharynx, larynx) that were 70 years old or older and proposed to receive radiation therapy according to medical criteria in the period 2008-2012. The sample was composed of the 95 % of the patients. A model for compiling the primary data was made. The information was obtained from the clinical histories. The variables of interest were analyzed. The results obtained were presented in tables and graphics. The statistical method of Kaplan-Meier was used to estimate the overall survival function.
Results: male sex predominated (76, 8 %) with a ratio of man to woman of 3:1. The most affected anatomical site was the oral cavity in the 40 % of the cases. The group of patients that do not develop acute toxicity by radiotherapy (64, 2 %) predominated. The most frequent type of acute toxicity was radiomucositis related to radiodermitis. The most used treatment was radiotherapy as a single modality and the most frequent administered total dose was between 60 and 69 Grays. The overall survival at 5 years was of 49, 3 %.
Conclusions: radiotherapy prevailed as a single treatment modality with acceptable acute toxicity levels. The overall survival at 5 years was similar to those reported in international studies.

REFERENCES

1. 1- Abraham J, Gulley JL, Allegra CJ. Bethesda Handbook of Clinical Oncology. 3ra ed. Philadel-phia: Lippincott Williams & Wilkins; 2010.

2. 2- Ministerio de Salud Pública. Anuario Estadístico de Salud 2013. La Habana: MINSAP; 2014.

3. 3- Gregoire V, Lefebvre JL, Licitra L, Felip E. Squamous cell carcinoma of the head and neck: EHNS–ESMO–ESTRO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann On-col. 2010 May;21 Suppl 5:v184–6.

4. 4- Hansen EK, Roach III M. Handbook of Evi-dence-Based Radiation Oncology. 2da ed. San Francisco: Springer; 2010.

5. 5- Soriano García JL, Galán Álvarez Y, Luaces Ál-varez P, Martín García A, Arrebola Suárez JA, Ca-rrillo Franco G. Incidencia en Cuba del cáncer en la tercera edad. Rev Cubana Oncol. Ago 1998;14(2):121-8.

6. 6- Wyss A, Mia H, Shu-Chun Ch, Yuan-Chin AL, Zuo-Feng Z, Guo-Pei Y, et al. Cigarette, Cigar, and Pipe Smoking and the Risk of Head and Neck Cancers: Pooled Analysis in the International Head and Neck Cancer Epidemiology Consortium. Am J Epidemiol. 2013 Sep;178(5):679–90.

7. 7- Mehanna H, Paleri V, West CML, Nutting C. Head and neck cancer-Part 1: Epidemiology, presentation and prevention. Clin Otolaryngol. 2011 Feb;36(1):65-8.

8. 8- Langevin SM, McClean MD, Michaud DS, Eliot M, Nelson HH, Kelsey KT. Occupational dust ex-posure and head and neck squamous cell carcino-ma risk in a population-based case–control study conducted in the greater Boston area. Cancer Medicine. 2013 Dec;2(6):978–86.

9. 9- Vanderwalde NA, Fleming M, Weiss J, Chera BS. Treatment of Older Patients With Head and Neck Cancer: A Review. The Oncologist. 2013 May;18:568–78.

10. 10- Sher DJ, Neville BA, Chen AB, Schrag D. Pre-dictors of IMRT and conformal radiotherapy use in head and neck squamous cell carcinoma: a SEER medicare analysis . Int J Radiat Oncol Biol Phys. 2011 Nov;81(4):197-206.

11. 11- Gupta T, Jain S, Agarwal JP, Ghosh-Laskar S, Phurailatpam R, Pai-Shetty R, et al. Prospective assessment of patterns of failure after high precision definitive chemoradiation in head and neck squamous cell carcinoma. Int J Radiat Oncol Biol Phys. 2011 Jun;80(2):522-31.

12. 12- Dirix P, Nuyts S. Value of IMRT in stage IV head and neck squamous cell carcinoma. Int J Ra-diat Oncol Biol Phys. 2010 Dec;78(5):1373-80.

13. 13- Spiotto MT, Weichselbaum RR. Comparison of 3D Conformal Radiotherapy and Intensity Modulated Radiotherapy with or without Simulta-neous Integrated Boost during Concurrent Chemo-radiation for Locally Advanced Head and Neck Cancers. PLoS One. 2014 Apr;9(4):e94456.

14. 14- Gómez-Millán J. Radiation therapy in the el-derly: More side effects and complications? Crit Rev Oncol Hematol. 2009 Jul;71(1):70-8.

15. 15- Das S, Thomas S, Pal SK, Isiah R, John S. Hypofractionated Palliative Radiotherapy in Locally Advanced Inoperable Head and Neck Cancer: CMC Vellore Experience. Indian J Palliat Care. 2013 May;19(2):93–8.

16. 16- Schmidt Santos RC, Dias RS, Giordani AJ, Segreto RA, Comodo Segreto HR. Mucositis in head and neck cancer patients undergoing radi-ochemotherapy. Rev Esc Enferm USP. 2011 Dec;45(6):1336-42.

17. 17- Braakhuis BJM, Brakenhoff RH, René Leemans C. Treatment choice for locally advanced head and neck cancers on the basis of risk factors: biologi-cal risk factors. Ann Oncol. 2012 Sep;23 Suppl 10:x173–7.

18. 18- Gupta S, Kong W, Booth CM, Mackillop WJ. Impact of concomitant chemotherapy on out-comes of radiation therapy for head-and-neck cancer: a population-based study. Int J Radiat On-col Biol Phys. 2014 Jan;88(1):115-121.

19. 19- Van Gestel D, Van den Weyngaert D, Schrijvers D, Weyler J, Vermorken JB. Intensity-modulated radiotherapy in patients with head and neck cancer: a European single-centre experience. Br J Radiol. 2011 Apr;84:367–74.