Radiothérapie externe accélérée postopératoire des carcinomes épidermoïdes localement évolués de la sphère ORL : étude prospective de phase II

Abstract
Purpose. – To assess the feasibility and efficacy of accelerated postoperative radiation therapy (RT) in patients with squamous-cell
carcinoma of the head and neck (SCCHN).
Patients and methods. – Between December 1997 and July 2001, 68 patients (male to female ratio: 52/16; median age: 60-years (range:
43–81) with pT1-pT4 and/or pN0-pN3 SCCHN (24 oropharynx, 19 oral cavity, 13 hypopharynx, 5 larynx, 3 unknown primary, 2 maxillary
sinus, and 2 salivary gland) were included in this prospective study. Postoperative RT was indicated because extracapsular infiltration (ECI)
* Auteur correspondant.
Adresse e-mail : abderrahim.zouhair@chuv.hospvd.ch (A. Zouhair).
Cancer/Radiothérapie 7 (2003) 231–236
www.elsevier.com/locate/canrad
© 2003 Éditions scientifiques et médicales Elsevier SAS. Tous droits réservés.
doi:10.1016/S1278-3218(03)00041-6
was observed in 20 (29%), positive surgical margins (PSM) in 20 (29%) or both in 23 patients (34%). Treatment consisted of external beam RT
66 Gy in 5 weeks and 3 days. Median follow-up was 15 months.
Results. – According to CTC 2.0, acute morbidity was acceptable: grade 3 mucositis was observed in 15 (22%) patients, grade 3 dysphagia
in 19 (28%) patients, grade 3 skin erythema in 21 (31%) patients with a median weight loss of 3.1 kg (range: 0–16). No grade 4 toxicity was
observed. Median time to relapse was 13 months; we observed only three (4%) local and four (6%) regional relapses, whereas eight (12%)
patients developed distant metastases without any evidence of locoregional recurrence. The 2 years overall-, disease-free survival, and
actuarial locoregional control rates were 85, 73 and 83% respectively.
Conclusion. – The reduction of the overall treatment time using postoperative accelerated RT with weekly concomitant boost (six fractions
per week) is feasible with local control rates comparable to that of published data. Acute RT-related morbidity is acceptable.