1
|
Milbury K, Rosenthal DI, Li Y, Ngo-Huang AT, Mallaiah S, Yousuf S, Fuller CD, Lewis C, Bruera E, Cohen L. Dyadic Yoga for Head and Neck Cancer Patients Undergoing Chemoradiation and their Family Caregivers. J Pain Symptom Manage 2024; 67:490-500. [PMID: 38447621 DOI: 10.1016/j.jpainsymman.2024.02.565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 02/19/2024] [Accepted: 02/27/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVES Concurrent chemoradiation to treat head and neck cancer (HNC) may result in debilitating toxicities. Targeted exercise such as yoga therapy may buffer against treatment-related sequelae; thus, this pilot RCT examined the feasibility and preliminary efficacy of a yoga intervention. Because family caregivers report low caregiving efficacy and elevated levels of distress, we included them in this trial as active study participants. METHODS HNC patients and their caregivers were randomized to a 15-session dyadic yoga program or a waitlist control (WLC) group. Prior to randomization, patients completed standard symptom (MDASI-HN) and patients and caregivers completed quality of life (SF-36) assessments. The 15-session program was delivered parallel to patients' treatment schedules. Participants were re-assessed at patients' last day of chemoradiation and again 30 days later. Patients' emergency department visits, unplanned hospital admissions and gastric feeding tube placements were recorded over the treatment course and up to 30 days later. RESULTS With a consent rate of 76%, 37 dyads were randomized. Participants in the yoga group completed a mean of 12.5 sessions and rated the program as "beneficial." Patients in the yoga group had clinically significantly less symptom interference and HNC symptom severity and better QOL than those in the WLC group. They were also less likely to have a hospital admission (OR = 3.00), emergency department visit (OR = 2.14), and/or a feeding tube placement (OR = 1.78). CONCLUSION Yoga therapy appears to be a feasible, acceptable, and possibly efficacious behavioral supportive care strategy for HNC patients undergoing chemoradiation. A larger efficacy trial is warranted.
Collapse
Affiliation(s)
- Kathrin Milbury
- Department of Behavioral Science (K.M., S.Y.), 1155 Pressler St., Houston, Texas 77030, USA.
| | - David I Rosenthal
- Department of Radiation Oncology (D.I.R., C.D.F.), 1515 Holcombe Blvd., Houston, Texas 77030, USA
| | - Yisheng Li
- Department of Biostatistics (Y.L.), 1515 Holcombe Blvd., Houston, Texas 77030, USA
| | - An Thuy Ngo-Huang
- Department of Palliative, Rehabilitation & Integrative Medicine (A.T.N.-H., S.M., E.B.,L.C.), 1515 Holcombe Blvd., Houston, Texas 77030, USA
| | - Smitha Mallaiah
- Department of Palliative, Rehabilitation & Integrative Medicine (A.T.N.-H., S.M., E.B.,L.C.), 1515 Holcombe Blvd., Houston, Texas 77030, USA
| | - Sania Yousuf
- Department of Behavioral Science (K.M., S.Y.), 1155 Pressler St., Houston, Texas 77030, USA
| | - Clifton D Fuller
- Department of Radiation Oncology (D.I.R., C.D.F.), 1515 Holcombe Blvd., Houston, Texas 77030, USA
| | - Carol Lewis
- Department of Head and Neck Surgery (C.L.), The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, Texas 77030, USA
| | - Eduardo Bruera
- Department of Palliative, Rehabilitation & Integrative Medicine (A.T.N.-H., S.M., E.B.,L.C.), 1515 Holcombe Blvd., Houston, Texas 77030, USA
| | - Lorenzo Cohen
- Department of Palliative, Rehabilitation & Integrative Medicine (A.T.N.-H., S.M., E.B.,L.C.), 1515 Holcombe Blvd., Houston, Texas 77030, USA
| |
Collapse
|
2
|
Durrani S, Contreras J, Mallaiah S, Cohen L, Milbury K. The Effects of Yoga in Helping Cancer Patients and Caregivers Manage the Stress of a Natural Disaster: A Brief Report on Hurricane Harvey. Integr Cancer Ther 2019; 18:1534735419866923. [PMID: 31364416 PMCID: PMC6669833 DOI: 10.1177/1534735419866923] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 02/27/2019] [Accepted: 07/01/2019] [Indexed: 12/29/2022] Open
Abstract
Background: This small qualitative study reports on the experiences of patients and family caregivers who participated in a dyadic yoga pilot trial while undergoing cancer treatment in the midst of Hurricane Harvey. Our primary purpose was to determine if participants implemented components of the program to cope with the stressors associated with Hurricane Harvey and if they perceived benefits from the yoga practices. Methods: We administered brief semistructured interviews to the dyads participating in a dyadic yoga pilot trial. Participants (n = 5 dyads) were asked to discuss their experience with Hurricane Harvey, including factors that helped them cope with the event while receiving treatment. Result: Patients had a mean age of 55.6 years, were mostly non-Hispanic White, male, and had advance stage head and neck cancer. Caregivers had a mean age of 58 years and were mainly non-Hispanic White and female. Analyses of the interviews revealed 2 overarching themes: (1) the storm's negative impact and (2) the use of yoga to cope with the hurricane-related stressors. Conclusions: Patient-caregiver dyads experienced psychological distress during the storm and/or its aftermath. Dyads used yoga techniques to cope with these psychological stressors. Yoga served as a means of social support as dyads either participated in these activities together or with other family members.
Collapse
Affiliation(s)
- Sania Durrani
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Smitha Mallaiah
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lorenzo Cohen
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kathrin Milbury
- The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| |
Collapse
|
3
|
Baine MJ, Dorius T, Bennion N, Smith L, Zhen W, Ganti AK. Weight Loss and Percutaneous Endoscopic Gastrostomy Tube Placement during Chemoradiotherapy for Locally Advanced Cancer of the Oropharynx Do Not Negatively Impact Outcomes. Front Oncol 2017; 7:299. [PMID: 29379770 PMCID: PMC5770811 DOI: 10.3389/fonc.2017.00299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 11/20/2017] [Indexed: 01/27/2023] Open
Abstract
Objectives Concurrent chemoradiotherapy is standard of care in locally advanced oropharyngeal cancer (LA-OPC). This treatment regimen results in significant acute toxicities. This study investigates the effect of treatment-related toxicity on patient outcomes. Methods Patient information was retrospectively collected for patients treated for LA-OPC between 2007 and 2014. Factors analyzed included age, gender, pretreatment ECOG performance status, smoking history, patient BMI prior to and following treatment, tumor histology, disease stage, disease recurrence, incidence, and timing of feeding tube placement, radiation dose received, chemotherapy regimen used and if it was completed, and patient survival. All statistical analysis was provided through the University of Nebraska Medical Center Department of Biostatistics. Results 74 patients were identified with a median follow-up of 3.4 years and a median age of 58.5. Most patients were male (87.8%) and had squamous cell histology (98.7%). Most patients underwent chemoradiotherapy alone (98.6%) and received concurrent cisplatin (78.4%) with approximately half (53.4%) receiving all planned chemotherapy. Upon multivariate analysis, both disease-free (DFS) and overall survival (OS) rates were improved by lower pretreatment BMI, increased weight lost during treatment, and lack of percutaneous endoscopic gastrostomy (PEG) tube placement prior to treatment initiation. Neither DFS nor OS was impacted by placement of a PEG tube during active treatment. Conclusion These data suggest that weight loss and PEG tube placement during chemoradiotherapy for LA-OPC, presumably due to treatment-associated mucositis and xerostomia, are not associated with worse outcomes.
Collapse
Affiliation(s)
- Michael J Baine
- Department of Radiation Oncology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, United States
| | - Timothy Dorius
- Department of Medical Oncology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, United States
| | - Nathan Bennion
- Department of Radiation Oncology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, United States
| | - Lynette Smith
- Center for Collaboration on Research Design and Analysis, Department of Biostatistics, University of Nebraska Medical Center, Omaha, NE, United States
| | - Weining Zhen
- Department of Radiation Oncology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, United States
| | - Apar Kishor Ganti
- Department of Medical Oncology, Fred and Pamela Buffett Cancer Center, University of Nebraska Medical Center, Omaha, NE, United States
| |
Collapse
|
4
|
Baine M, Dorius T, Bennion N, Alam M, Smith L, Zhen W, Ganti A. Chemoradiotherapy for locally advanced squamous cell carcinoma of the oropharynx: Does completion of systemic therapy affect outcomes? Oral Oncol 2017; 73:105-110. [DOI: 10.1016/j.oraloncology.2017.08.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 07/31/2017] [Accepted: 08/27/2017] [Indexed: 10/18/2022]
|
5
|
Long-term outcomes with high-dose-rate brachytherapy for the management of base of tongue cancer. Brachytherapy 2013; 12:535-41. [DOI: 10.1016/j.brachy.2013.07.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Revised: 06/10/2013] [Accepted: 07/03/2013] [Indexed: 11/19/2022]
|
6
|
O'Connell D, Seikaly H, Murphy R, Fung C, Cooper T, Knox A, Scrimger R, Harris JR. Primary surgery versus chemoradiotherapy for advanced oropharyngeal cancers: a longitudinal population study. J Otolaryngol Head Neck Surg 2013; 42:31. [PMID: 23663568 PMCID: PMC3668157 DOI: 10.1186/1916-0216-42-31] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 03/18/2013] [Indexed: 12/03/2022] Open
Abstract
Background Treatment for advanced stage oropharyngeal squamous cell carcinoma (OPSCC) includes combined chemoradiation therapy or surgery followed by radiation therapy alone or in combination with chemotherapy. The goal of this study was to utilize available evidence to examine survival outcome differences in patients with advanced stage OPSCC treated with these different modalities. Methods Patients with advanced stage OPSCC were identified. Primary outcome measurements were disease specific and overall survival rates with differences examined via Kaplan-Meier and logistic regression analysis. Results 344 patients were enrolled. 94 patients underwent triple modality therapy inclusive of surgery followed by adjuvant combined chemotherapy and radiation therapy (S-CRT). 131 had surgery and radiation therapy (S-RT), while 56 had chemoradiation (CRT) therapy as their primary treatment. A total of 63 patients had single modality radiation therapy and were excluded from analysis due to the large number of palliative patients. Kaplan-Meier overall survival analysis showed that therapy with S-CRT had the highest disease specific survival at five years (71.1%). This is contrasted against S-RT and CRT, with five year survival rates at 53.9%, and 48.6%, respectively. Cox regression showed that the comparison of S-CRT vs. S-RT, and CRT is associated with statistically significant increased hazard ratios of 1.974, and 2.785, indicating that both S-RT and CRT are associated with a reduced likelihood of survival at 5 years when compared to S-CRT. Conclusions In this population based cohort study S-CRT is associated with a 17–22% 5 year disease specific survival benefit compared to CRT or S-RT.
Collapse
Affiliation(s)
- Daniel O'Connell
- Division of Otolaryngology-Head & Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - Hadi Seikaly
- Division of Otolaryngology-Head & Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - Russell Murphy
- Division of Otolaryngology-Head & Neck Surgery, University of Alberta, Edmonton, AB, Canada
| | - Charles Fung
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Tim Cooper
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Aaron Knox
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Rufus Scrimger
- Division of Radiation Oncology, University of Alberta, Edmonton, AB, Canada
| | - Jeffrey R Harris
- Division of Otolaryngology-Head & Neck Surgery, University of Alberta, Edmonton, AB, Canada ; 1E4.29 Walter C. MacKenzie Health Sciences Centre, 8440 112 Street, Edmonton, AB T6G 1B7, Canada
| |
Collapse
|
7
|
Jilani OK, Singh P, Wernicke AG, Kutler DI, Kuhel W, Christos P, Nori D, Sabbas A, Chao KC, Parashar B. Radiation therapy is well tolerated and produces excellent control rates in elderly patients with locally advanced head and neck cancers. J Geriatr Oncol 2012; 3:S1879-4068(12)00045-8. [PMID: 24386015 DOI: 10.1016/j.jgo.2012.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
PURPOSE Management of locally advanced head and neck cancer (LAHNC) in the elderly is challenging due to multiple co-morbidities, poor organ function and performance status. The aim of this study was to evaluate efficacy of radiation therapy (RT) in elderly patients, defined as 65 years and older, with high-risk LAHNC. MATERIALS AND METHODS An IRB approved retrospective chart review of elderly patients was performed, of whom 73 patients were selected for analysis. The stages included were II/III-IV. Sites included were oropharynx, oral cavity, larynx, salivary gland, nasopharynx, nasal cavity, paranasal sinus, hypopharynx and unknown primary. RESULTS Median age was 74 years. Thirty nine (53%) patients received concurrent chemotherapy. Median time to completion of RT was 53 days. Median external beam radiotherapy (EBRT) dose was 66 Gy. With a median follow-up of 24 months, overall local control (LC) was 80% and distant metastasis (DM) was 12%. Sixty patients (82%) were alive at the time of study. Two-year overall survival (OS) was 96% (95% CI=87%, 99%). Chemotherapy did not improve LC [80% (chemo) vs 79% (no chemo), p=0.88] or DM [11% (chemo) vs 14% (no chemo), p=0.73]. Interestingly, patients receiving RT using intensity-modulated radiation therapy (IMRT) had a significantly higher rate of LC vs three-dimensional conformal radiotherapy (3DCRT) (94% vs 68%, respectively, p=0.008). Grade 2/3 toxicity was seen in 70/73 (96%) patients while grade 4 toxicity was seen in three patients (4%). CONCLUSION Elderly patients with LAHNC have high rates of LC and OS. Prospective studies can reveal more insight into this increasingly important clinical problem in elderly patients.
Collapse
Affiliation(s)
- Omar K Jilani
- Stich Radiation Center, Weill Cornell Medical Center, New York, NY 10065
| | | | | | - David I Kutler
- Department of Otorhinolaryngology, Weill Cornell Medical Center, New York, NY 10065
| | - William Kuhel
- Department of Otorhinolaryngology, Weill Cornell Medical Center, New York, NY 10065
| | - Paul Christos
- Division of Biostatistics and Epidemiology, Department of Public Health, Weill Cornell Medical Center, New York, NY 10065
| | - Dattatreyudu Nori
- Stich Radiation Center, Weill Cornell Medical Center, New York, NY 10065
| | - Albert Sabbas
- Stich Radiation Center, Weill Cornell Medical Center, New York, NY 10065
| | - Ks Clifford Chao
- Stich Radiation Center, Weill Cornell Medical Center, New York, NY 10065
| | - Bhupesh Parashar
- Stich Radiation Center, Weill Cornell Medical Center, New York, NY 10065
| |
Collapse
|
8
|
Pederson AW, Haraf DJ, Witt ME, Stenson KM, Vokes EE, Blair EA, Salama JK. Chemoradiotherapy for locoregionally advanced squamous cell carcinoma of the base of tongue. Head Neck 2011; 32:1519-27. [PMID: 20187015 DOI: 10.1002/hed.21360] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Our aim was to report the outcomes of base of tongue cancers treated with chemoradiotherapy. METHODS Between 1990 and 2004, 127 patients with stage III or IV base of tongue cancer were treated with chemoradiotherapy on protocol. Indications included nodal involvement, T3/T4 tumors, positive margins, those patients refusing surgery, or were medically inoperable. The most common regimen was paclitaxel (100 mg/m2 on day 1), infusional 5-fluorouracil (600 mg/m2/day × 5 days), hydroxyurea (500 mg prescribed orally [PO] 2 × daily [BID]), and 1.5 Gy twice daily irradiation followed by a 9-day break without treatment. RESULTS Median follow-up was 51 months. The median dose to gross tumor was 72.5 Gy (range, 40-75.5 Gy). Five-year locoregional progression-free survival, overall survival, and disease-free survival was 87.0%, 58.2%, and 46.0%, respectively. CONCLUSION Concurrent chemoradiotherapy results in promising locoregional control for base of tongue cancer. As distant relapse was common, further investigation of systemic therapy with novel agents may be warranted.
Collapse
Affiliation(s)
- Aaron W Pederson
- Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA
| | | | | | | | | | | | | |
Collapse
|
9
|
Chemoradiation for advanced head and neck cancer: potential for improving results to match those of current treatment modalities for early-stage tumors--long-term results of hyperfractionated chemoradiation with carbogen breathing and anemia correction with erythropoietin. Int J Radiat Oncol Biol Phys 2007; 70:1382-8. [PMID: 18037586 DOI: 10.1016/j.ijrobp.2007.08.068] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2007] [Revised: 08/10/2007] [Accepted: 08/10/2007] [Indexed: 11/21/2022]
Abstract
PURPOSE To attempt to improve results of chemoradiation for head and neck cancer. METHODS AND MATERIALS From March 1996 to April 2007, 98 patients with head and neck cancer (15 Stage III and 83 Stage IV) were treated with a twice-daily hyperfractionated schedule. Eleven patients presented with N0, 11 with N1, 13 with N2A, 17 with N2B, 24 with N2C, and 22 with N3. Each fraction of treatment consisted of 5 mg/m(2) of carboplatin plus 115 cGy with carbogen breathing. Treatment was given 5 days per week up to total doses of 350 mg/m(2) of carboplatin plus 8050 cGy in 7 weeks. Anemia was corrected with erythropoietin. RESULTS Ninety-six patients tolerated the treatment as scheduled. All patients tolerated the planned radiation dose. Local toxicity remained at the level expected with irradiation alone. Chemotherapy toxicity was moderate. Ninety-seven complete responses were achieved. After 11 years of follow-up (median, 81 months), actuarial locoregional control, cause-specific survival, overall survival, and nodal control rates at 5 and 10 years were, respectively, 83% and 83%, 68% and 68%, 57% and 55%, and 100% and 100%. Median follow-up of disease-free survivors was 80 months. No significant differences in survival were observed between the different subsites or between the pretreatment node status groups (N0 vs. N+, N0 vs. N1, N0 vs. N2A, N0 vs. N2B, N0 vs. N2C, and N0 vs. N3). CONCLUSIONS Improving results of chemoradiation for advanced head and neck cancer up to the level obtained with current treatments for early-stage tumors is a potentially reachable goal.
Collapse
|
10
|
Ijuin T, Nibu KI, Doi K, Inoue H, Saitoh M, Ohtsuki N, Makino K, Amatsu M. Thymidine phosphorylase mRNA level predicts survival of patients with advanced oropharyngeal cancer. Acta Otolaryngol 2007; 127:305-11. [PMID: 17364369 DOI: 10.1080/00016480600801381] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
CONCLUSION The present study suggested that a high level of thymidine phosphorylase (TP) gene expression is significantly associated with favorable prognosis of patients treated with 5-fluorouracil (5-FU)-based chemotherapy. Further studies consisting of large series should be performed to confirm our present results. BACKGROUND Expression levels of the thymidylate synthase (TS) and 5-FU metabolic enzymes including dihydropyrimidine dehydrogenase (DPD), TP, and orotate phosphoribosyl transferase (OPRT), are reported to be associated with sensitivity to 5-FU-based chemotherapy in several cancers. PATIENTS AND METHODS Intratumoral mRNA expression levels of TS, DPD, TP, and OPRT in pretreatment biopsy specimens were quantified in 27 patients with advanced oropharyngeal squamous cell carcinomas. Association of these expression levels with response to platinum and 5-FU-based chemotherapy and survival were analyzed statistically. RESULTS By Spearman's correlation analysis, significant correlation was observed between TS and TP (gamma=0.51, p=0.018). While no correlation was observed between the tumor regression and expression of any of the genes investigated, significant association was observed between prognosis and mRNA expression levels of TS and TP. Multivariate Cox regression analysis revealed that TP mRNA expression level is a significant factor predicting prognosis (hazard ratio (HR) = - 0.204, p=0.043).
Collapse
Affiliation(s)
- Takahiro Ijuin
- Department of Otolaryngology-Head and Neck Surgery, Kobe University Hospital, Kobe, Japan
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Zhen W, Karnell LH, Hoffman HT, Funk GF, Buatti JM, Menck HR. The national cancer data base report on squamous cell carcinoma of the base of tongue. Head Neck 2006. [DOI: 10.1002/hed.20061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
|
12
|
Zhen W, Karnell LH, Hoffman HT, Funk GF, Buatti JM, Menck HR. The National Cancer Data Base report on squamous cell carcinoma of the base of tongue. Head Neck 2005; 26:660-74. [PMID: 15287033 DOI: 10.1002/hed.20064] [Citation(s) in RCA: 84] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND This study provides the largest contemporary overview of presentation, care, and outcome for base of tongue squamous cell carcinoma (SCC). METHODS We extracted 16,188 cases from the National Cancer Data Base (NCDB). Chi-square analyses were performed on selected cross-tabulations. Observed and disease-specific survival were used to analyze outcome. RESULTS Three-quarters had advanced-stage (III-IV) disease. Radiation therapy alone (24.5%) and combined with surgery (26.9%) were the most common treatments. Five-year observed and disease-specific survival rates were 27.8% and 40.3%, respectively. Poorer survival was significantly associated with older age, low income, and advanced-stage disease. For early-stage disease, surgery with or without irradiation had higher survival than irradiation alone. For advanced-stage disease, surgery with irradiation had the highest survival. CONCLUSIONS Survival rates were low for base of tongue SCC, with most deaths occurring within the first 2 years. Income, stage, and age were significant prognostic factors. In this nonrandomized series, surgery with radiation therapy offered patients with advanced-stage disease the best survival.
Collapse
Affiliation(s)
- Weining Zhen
- Department of Radiation Oncology and Department of Otolaryngology-Head and Neck Surgery, University of Nebraska Medical Center, 987521 Nebraska Medical Center, Omaha, Nebraska 68198-7521, USA
| | | | | | | | | | | |
Collapse
|