Author/Editor     Šmid, Lojze; Budihna, Marjan; Zakotnik, Branko; Šoba, Erika; Strojan, Primož; Fajdiga, Igor; Žargi, Miha; Oblak, Irena; Dremelj, Marta; Lešničar, Hotimir
Title     Postoperative concomitant irradiation and chemotherapy with mitomycin C and bleomycin for advanced head-and-neck carcinoma
Type     članek
Source     Int J Radiat Oncol Biol Phys
Vol. and No.     Letnik 56, št. 4
Publication year     2003
Volume     str. 1055-62
Language     eng
Abstract     Purpose: In a prospective randomized ctinical study, simultaneous postoperative application of irradiation (RT), mitomycin C, and bleomycin was tested in a group of patients with operable advanced head-and-neck carcinoma. It was expected that the planned combined postoperative therapy would reduce the number of locoregional recurrences and prolong survival. Methods and Materials: A total of 114 eligible patients with Stage III or IV squamous cell head-and-neck carcinoma were randomized to receive postoperative RT alone (Group 1) or RT combined with simultaneous mitomycin C and bleomycin (Group 2). Patients were stratified according to the stage and site of the primary tumor and the presence or absence of high-risk prognostic factors. Primary surgical treatment was performed with curative intent in alt patients. Patients in both groups were postoperatively irradiated to the total dose of 56-70 Gy. Chemotherapy included mitomycin C 15 mg/m2 after 10 Gy and S mg of bleomycin twice a week during RT to the planned total dose of 70 mg. Results: At 2 years, patients in the radiochemotherapy group had better locoregional control (86%) than those in the RT alone group (69%; p = 0.037). Disease-free survival and overall survival was also better in the radiochemotherapy group compared with the RT-alone group (76% vs. 60%,p = 0.099; and 74% vs. 64%,p = 0.036, respectively). Patients who benefited from chemotherapy were those with high-risk factors. Conclusion: The results of the present study indicate that concomitant postoperative radiochemotherapy with mitomycin C and bleomycin improves locoregional control and survival in patients with advanced head-and-neck carcinoma. The patients who benefited from chemotherapy were those with high-risk factors.
Descriptors     BLEOMYCIN
HEAD AND NECK NEOPLASMS
MITOMYCIN C
POSTOPERATIVE CARE
SURVIVAL ANALYSIS
DISEASE-FREE SURVIVAL