Impact of the treating institution on the survival of patients with head and neck cancer treated with concomitant alternating chemotherapy and radiation

M. Benasso, R. Lionetto, R. Corvò, A. Ponzanelli, V. Vitale, R. Rosso

Research output: Contribution to journalArticlepeer-review

Abstract

The aim of this study was to investigate the possible impact of the treating institution on the survival of patients with advanced squamous cell carcinoma of the head and neck treated with radiotherapy alone or concomitant alternating chemotherapy and radiation. The National Institute for Cancer Research of Genoa (IST) was the coordinator of two multicentre randomised trials comparing an alternating chemotherapy and radiation approach to radiotherapy alone with standard fractionation (HN-8 trial: 157 patients) or accelerated fractionation (HN-9 trial: 136 patients) in patients with advanced squamous-cell carcinoma of the head and neck. A single database of the two studies was created and a univariate analysis was performed. The Cox regression model, adjusted for the effect of other prognostic factors, was used to test the impact of the treating institution on survival. Three-year overall survival was 46% for patients treated with chemotherapy and radiation at the coordinating centre and 27% for those treated with the same approach at the affiliated centres (P=0.0001). No difference was detected between patients treated with radiation alone at the coordinating centre or outside (23% versus 21%: P=0.52). The hazard ratio of death for patients treated at the affiliated centres with concomitant alternating chemotherapy and radiation was 2.15 (95% Confidence Interval (C.I.) 1.45-3.18), while it was 1.003 (95% C.I. 0.65-1.55) for those treated with radiation alone. In our experience, the treating institution had a significant impact only on the prognosis of patients treated with the multidisciplinary approach. This finding has implications, both in terms of clinical research and clinical practice.

Original languageEnglish
Pages (from-to)1895-1898
Number of pages4
JournalEuropean Journal of Cancer
Volume39
Issue number13
DOIs
Publication statusPublished - Sep 2003

Keywords

  • Alternating chemotherapy and radiation
  • Head and neck
  • Outcomes
  • Treating institution

ASJC Scopus subject areas

  • Cancer Research
  • Hematology
  • Oncology

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