Publication: Lokal ileri evre skuamöz hücreli baş ve boyun kanserinde sisplatinle eş zamanlı kemoradyoterapi: Yan etki ve uygulanabilirlik analizi
Abstract
AMAÇ Bu çalışmada, lokal ileri evre skuamöz hücreli baş ve boyun kanseri tanılı hastalarda eş zamanlı kemoradyoterapi (KRT) sırasında görülen yan etkiler analiz edilmiş, hasta, hastalık ve tedaviye bağlı faktörlerin eş zamanlı tedavinin tamamlanabilirliği üzerine etkisi incelenmiştir. GEREÇ VE YÖNTEM Kliniğimizde 2001-2007 yılları arasında konvansiyonel radyoterapi şemasıyla ortanca 70 Gy (50-73 Gy) tedavi görmüş 49’u primer, 16’sı adjuvan toplam 65 hasta çalışmaya dahil edildi. Hastalara eş zamanlı sisplatin 3 haftada bir 60-80 mg/m2 (n=57) ya da haftalık 40 mg/m2 (n=8) olarak uygulandı. BULGULAR Eş zamanlı kemoterapi hastaların % 4 6,1’inde planlanan şekilde uygulanabildi. Kemoterapi durdurma nedenleri arasında derece 3 ve üzeri yan etki (%41,6) yanında hasta reddi (%19,4) ve hekim kararı (%33,3) vardı. Radyoterapi öncesi Karnofsky Performans Durumu (KPS) ≥90 olan hastalarda eş zamanlı sisplatinin tamamlanma oranı %63,8 iken, bu oran KPS <90 hastalarda %24,1 idi (p=0,001). SONUÇ Artan şiddet ve sıklıktaki yan etkiler eş zamanlı tedavilerin uygulanabilirliğini etkilemektedir. Çalışmamız kombine tedavi öncesi performans durumunun KRT’nin tamamlanabilirliğinde belirleyici olabileceğini göstermektedir.
OBJECTIVES In this study, we assessed the side effects and the factors related to patients, disease and, treatment that might change the decision for concurrent chemoradiotherapy (CRT) in locally advanced head and neck cancer. METHODS A total of 65 patients (49 primary; 16 postoperative) who received curative radiotherapy (median 70 Gy) with conventional fractionation schedule were enrolled into the study. Concomitant cisplatin were administered either 60-80 mg/m2 every 3 weeks (n=57) or 40 mg/m2 weekly (n=8). RESULTS Concurrent chemotherapy was completed in 46.1% patients. Premature chemotherapy termination was done due to grade 3 adverse event (41.6%), patients&#8217; refusal (19.4%) or physician decision (33.3%). Initial Karnofsky Performance Status (KPS) significantly predicted concurrent chemotherapy completeness (KPS &#8805;90, 63.8% vs KPS <90, 24.1%; p=0.001). CONCLUSION Despite the promising results, concurrent CRT requires careful consideration for toxicity. Initial performance status prior to CRT might be a predictor for unplanned chemotherapy stopping due to side effects.
OBJECTIVES In this study, we assessed the side effects and the factors related to patients, disease and, treatment that might change the decision for concurrent chemoradiotherapy (CRT) in locally advanced head and neck cancer. METHODS A total of 65 patients (49 primary; 16 postoperative) who received curative radiotherapy (median 70 Gy) with conventional fractionation schedule were enrolled into the study. Concomitant cisplatin were administered either 60-80 mg/m2 every 3 weeks (n=57) or 40 mg/m2 weekly (n=8). RESULTS Concurrent chemotherapy was completed in 46.1% patients. Premature chemotherapy termination was done due to grade 3 adverse event (41.6%), patients&#8217; refusal (19.4%) or physician decision (33.3%). Initial Karnofsky Performance Status (KPS) significantly predicted concurrent chemotherapy completeness (KPS &#8805;90, 63.8% vs KPS <90, 24.1%; p=0.001). CONCLUSION Despite the promising results, concurrent CRT requires careful consideration for toxicity. Initial performance status prior to CRT might be a predictor for unplanned chemotherapy stopping due to side effects.