Locoregional failure and the risk of distant metastasis after modern radiotherapy for head and neck cancer.

Academic Article

Abstract

  • BACKGROUND: Evolving epidemiology and improvements in locoregional therapy necessitate reassessment of the relationship between locoregional failure and distant metastasis in squamous cell carcinoma of the head and neck (SCCHN). METHODS: Retrospective assessments of factors associated with distant metastasis-free survival were made for 560 patients with SCCHN who received definitive radiotherapy (RT) +/- concurrent systemic therapy at our institution between 1995 and 2007. RESULTS: Fifty-six patients (10.0%) developed distant metastasis. Three-year actuarial locoregional control and distant metastasis-free survival were 72% and 87%, respectively. Multivariate analysis revealed N classification and locoregional failure as significant predictors of reduced distant metastasis-free survival (p < .001). In patients with distant metastasis detected after locoregional failure, the mean interval between these events was 11.6 months. CONCLUSION: Locoregional failure may play a causative role for distant metastasis in some patients with SCCHN, suggesting a need for continued focus on improving locoregional therapies.
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    Keywords

  • Adult, Aged, Aged, 80 and over, Carcinoma, Squamous Cell, Disease-Free Survival, Female, Head and Neck Neoplasms, Humans, Male, Middle Aged, Neoplasm Metastasis, Neoplasm Recurrence, Local, Retrospective Studies, Risk, Squamous Cell Carcinoma of Head and Neck, Treatment Outcome, Young Adult
  • Digital Object Identifier (doi)

    Author List

  • Dragovic AF; Caudell JJ; Spencer SA; Carroll WR; Nabell LA; Bonner JA
  • Start Page

  • 381
  • End Page

  • 387
  • Volume

  • 35
  • Issue

  • 3