Efficacy of intensity-modulated radiotherapy combined with chemotherapy or surgery in locally advanced squamous cell carcinoma of the head-and-neck

Figures & data

Table 1 Patient baseline characteristics and demographics (n = 61)

Factors	CIMRT	IMRT	χ^2	P-value	Definitive IMRT	Postop IMRT	χ^2	P-value
Gender			3.53	0.06			1.42	0.23
Male	31	18			12	37
Female	4	8			5	7
Age (years)			0.37	0.54			0.02	0.88
≤50	6	3			3	6
>50	29	23			16	36
Primary site			0.63	0.98			5.57	0.35
Oral	9	7			4	12
Oropharynx	1	1			1	1
Hypopharynx	8	5			3	10
Nasal and paranasal sinus	6	6			3	9
Larynx	10	6			5	11
Salivary gland	1	1			1	1
T stage			2.95	0.23			1.75	0.42
T2	8	8			4	12
T3	6	7			5	19
T4	10	11			8	13
N stage			3.14	0.27			2.05	0.36
N0	20	9			7	22
N1	8	10			4	14
N2	7	7			6	8
UICC stage			0.49	0.48			3.38	0.07
III	18	11			5	24
IVa	10	12			10	15
IVb	7	3			2	5

Abbreviations: CIMRT, chemotherapy combined with intensity-modulated radiation therapy; N, node; Postop IMRT, postoperative IMRT; T, tumor; UICC, International Union Against Cancer; IMRT, intensity-modulated radiation therapy.

Figure 1 Local recurrence-free, regional recurrence-free, distant metastasis-free, and overall survival rates in 61 patients treated with intensity-modulated radiotherapy with or without chemotherapy.

Abbreviations: Cum, cumulative; DMFS, distant metastasis-free survival; LRFS, local recurrence-free survival; OS, overall survival; RRFS, regional recurrence-free survival.

Figure 2 Overall survival of all patients was analyzed according to treatment modality. Postoperative IMRT had a superior OS compared with definitive IMRT (P = 0.019).

Abbreviations: Cum, cumulative; IMRT, intensity-modulated radiation therapy; OS, overall survival.

Table 2 Outcomes in 61 IMRT patients were analyzed according to use of chemotherapy and treatment modality

Factor	3-year OS (%)	χ^2	P-value	3-year LC (%)	χ^2	P-value	3-year DMFS (%)	χ^2	P-value
Chemotherapy		5.52	0.035		5.25	0.042		10.07	0.015
IMRT	59.7			67.0			65.3
CIMRT	74.1			83.8			79.0
Treatment modality		18.49	0.0019		12.02	0.011		8.07	0.038
Definitive IMRT	46.5			60.0			65.0
Postoperative IMRT	81.1			79.6			82.5

Abbreviations: CIMRT, chemotherapy combined with intensity-modulated radiation therapy; DMFS, distant metastasis-free survival; IMRT, intensity-modulated radiation therapy; LC, local control; OS, overall survival.

Figure 3 Overall survival (OS) of all patients was analyzed according to use of chemotherapy. Chemotherapy combined with intensity-modulated radiation therapy (CIMRT) had a superior OS compared to IMRT (P = 0.035).

Abbreviations: Cum, cumulative; OS, overall survival; IMRT, intensity-modulated radiation therapy.

Table 3 Acute and late toxicities observed in 61 patients with locally advanced squamous cell carcinoma of the head and neck (number [%])

Adverse effect	Grade 1	Grade 2	Grade 3	Grade 4
Skin reaction	40 (65.6)	18 (29.5)	1 (1.6)	0
Mucositis	35 (57.4)	16 (26.2)	1 (1.6)	0
Xerostomia	8 (13.1)	12 (19.7)	1 (1.6)	0
Disturbance of hearing	2 (3.2)	5 (8.0)	1 (1.6)	0
Dysphagia	0	1 (1.6)	0	0
Neck skin fibrosis	1 (1.6)	3 (4.8)	0	0