Loco-regional failures in XXXX : can they be effectively salvaged by nonsurgical therapeutic modalities?

@entity1 @entity135 @entity1349
BACKGROUND: This retrospective study was carried out to ascertain the extent of efficacy of nonsurgical salvage modalities, mainly chemotherapy (CT) alone or chemoradiotherapy (CTRT), for loco-regional failures in @entity135 ( @entity135 ). METHODS: Between 1991 and 1999, 131 @entity1 with @entity135 , mostly stages III and IV, who had loco-regional residual ( n = 78) or recurrent lesions ( n = 53) following curative therapy with either radiotherapy (RT), neoadjuvant CT (NACT) followed by RT, or concurrent CTRT were included in this analysis. Of these, 84 @entity1 (residual, 58; recurrent, 26), did not receive any form of salvage therapy, while 47 had either CT alone ( n = 22) or CTRT ( n = 25). Endpoints evaluated were: loco-regional response (LRR), post-salvage survival (PS), @entity1349 ( @entity1349 ), and normal tissue acute and late morbidities. RESULTS: Salvage therapy enabled a LRR in 46.8% of the @entity1 . Both @entity1349 and PS were also significantly better for those who received salvage therapy ( P < 0.001). CTRT appears to offer significantly better salvage than CT alone for all the evaluated endpoints. Multivariate analysis for LRR, PS, and @entity1349 consistently showed the salvage RT dose to be a significant predictor. Early and late effects of salvage therapy were not influenced by either the salvage or total RT doses. CONCLUSION: Loco-regional failures in advanced @entity135 can be effectively salvaged by CTRT to significantly prolong @entity1349 and PS. However, to achieve an optimum therapeutic ratio, the choice of drugs, their schedule, and the RT dose need to be defined through randomized trials.
