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Quality-of-Life Assessment After Supradose Selective Intra-arterial Cisplatin and Concomitant Radiation (RADPLAT) for Inoperable Stage IV Head and Neck Squamous Cell Carcinoma
Annemieke H. Ackerstaff, PhD;
I. Bing Tan, MD, PhD;
Coen R. N. Rasch, MD, PhD;
Alfons J. M. Balm, MD, PhD;
Ronald B. Keus, MD;
Jan H. Schornagel, MD, PhD;
Frans J. M. Hilgers, MD, PhD
Arch Otolaryngol Head Neck Surg. 2002;128:1185-1190.
Objective To evaluate quality-of-life (QOL) aspects of an organ preservation intra-arterial
chemotherapy and concomitant radiation protocol, RADPLAT.
Design Nonrandomized phase 2B feasibility trial.
Patients Fifty consecutive patients with inoperable stage IV head and neck cancer.
Intervention Supradose selective intra-arterial cisplatin and concomitant standard
radiation (RADPLAT).
Measures Assessment with structured questionnaires before treatment and at 3,
6, and 12 months.
Results Twenty-six patients were available for QOL assessment at 1 year (the
"1-year QOL" group), as 16 patients died, 5 needed salvage surgery, and 3
were not available for interview (the "failure" group). Twelve-month results
were mainly based on the first group. The functional well-being and head and
neck scales showed a statistically significant improvement over time (P<.001). After 12 months, 21 patients (81%) returned
to an oral diet, while 5 patients still needed tube feeding. For 23 patients
(88%), the quality and strength of the voice was more or less normal. Of the
18 patients who were employed before their treatment, 10 were able to return
to their job within 12 months. Xerostomia was reported by 17 patients (65%).
Further detailed analysis showed statistically significant differences in
pretreatment scores between the 1-year QOL group and the failure group, ie,
physical well-being, functional well-being, and the head and neck scales (P<.05). Differences in these groups with respect to
sex, age, tumor site, or stage could not be found.
Conclusion Given that only patients with locally (anatomic or functional) inoperable
stage IV disease were treated, the results are promising, underlining the
feasibility of the RADPLAT protocol.
From the Department of Otolaryngology, Head and Neck Surgery and Radiation
Oncology, The Netherlands Cancer Institute, Amsterdam.
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
RADPLAT: An Alternative to Surgery?
Alkureishi et al.
The Oncologist 2006;11:469-480.
ABSTRACT
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