JournalClubNew.pptVIP

Postoperative Irradiation with or withoutConcomitant Chemotherapy for Locally Advanced HeadNeck Cancer Background Local recurrences and distant metastases are frequent after surgery of stage III or IV HN squamous-cell carcinoma Particularly with inadequate resection margins, extranodal spread, or multiple involved lymph nodes. Background For locally advanced tumors, surgery is usually followed by adjuvant radiotherapy Combined therapy is a promising approach Objective Whether the addition of cisplatin to high-dose radiotherapy after radical surgery increases PFS in patients at high risk for recurrent cancer. Overall survival, relapse, and acute and late adverse effects. Eligibility Age from 18 to 70 Performance status of 0,1,2 WBC4000 /ml, PLT100,000 /ml HGB110g/ml Cr120 μmol /L ALT,AST80U/L STB34.2 μmol /L CB13.6 μmol /L Eligibility Untreated after operation Histologically: squamous-cell Ca From the oral cavity, oropharynx, hypopharynx,or larynx T3,T4,any N(except for T3N0 of the larynx);N2,N3 any T;and M0 Negative resection margins Method Method 4 to 6 MV-X; Isocentric techniques CTV DT 54 Gy/ 27f/ 5.5 W Regions that were at high risk for malignant dissemination or that had inadequate resection margins received a 12-Gy boost (total, 66 Gy/33f/ 6.5 W) Method Cisplatin 100 mg/m2 on D1, D22, and D43 of the course of radiotherapy Prophylactic hydration and antiemetic agents. Method Follow-up evaluation items: Tumor response Adverse effects Weight Performance status Results Characteristics of Tumors Results Characteristics of Tumors Results Characteristics of Tumors Results Follow-up Times (Month) Results Progress-free Survival Results Progress-free Survival Results Overall Survival Results Overall Survival Results Severe acute adverse effects(%) Results Only severe chemotherapy-related adverse effect(%) Results Late Adverse Effects of Grade 3 or Higher Results Late Adverse Effects of Grade 3 or Higher Results Other Secondary e