IMRT-SIB with concurrent and neo-adjuvant XXXX -based chemotherapy for locally advanced head and neck squamous cell cancer: analysis of clinical outcomes in a retrospective series of a single institution.

@entity1 @entity135 @entity137 @entity5 @entity2133 @entity33 @entity1282 @entity902
UNASSIGNED: Aims and background. To evaluate results of an intensity-modulated radiotherapy with simultaneous integrated boost schedule with concurrent and neo-adjuvant @entity902 -based chemotherapy for the definitive treatment of locally advanced @entity135 in a retrospective series. Methods and study design. Between May 2007 and February 2010, 28 consecutive @entity1 with locally advanced @entity135 (stage II, 11%; III, 18%; IV, 71%) received intensity-modulated radiotherapy with simultaneous integrated boost with concurrent and neoadjuvant (20/28 @entity1 ) chemotherapy, at 1.8 G/die to 54 Gy to the elective volume and 66 Gy (2.2 Gy/die) to the @entity5 volume. @entity137 were scored according to RTOG/EORTC. A quality of life questionnaire for late @entity2133 was also administered. Locoregional control and overall survival were estimated using Kaplan-Meier analysis. Results. Median follow-up was 50 months, there was no grade 4 acute/late @entity137 . Major acute @entity137 were grade 2+ @entity33 , 79%; grade 2+ @entity2133 , 54%; grade 2+ @entity1282 , 86%; 54% of @entity1 required parenteral nutrition. The most relevant late reaction was grade 1 @entity2133 (64%), which gradually recovered with time. A linear correlation between the RTOG/EORTC scale and the quality of life questionnaire value (P = 0.0120, r2 = 0.2641) was found, receiver operating characteristic analysis (ROC) confirmed sensitivity of the quality of life questionnaire to define grade 2 late salivary @entity137 (P = 0.019). Five-year actuarial locoregional control and overall survival were 81%    7.7 SE and 82%    7.3 SE, respectively. Conclusions. A prospective trial of the intensity-modulated radiotherapy with simultaneous integrated boost schedule tested in this retrospective series with concurrent and neoadjuvant chemotherapy seems warranted in order to establish this approach as a standard regimen of intensity-modulated radiotherapy with simultaneous integrated boost chemoradiation.
