Abstract
Background. Our aim was to determine whether percutaneous endoscopic gastrostomy (PEG) dependence was significantly different between 2 prospective trials with different radiation fractionation schemes. Methods. Stage III or IV locally advanced head and neck squamous cell carcinomas arising from the oral cavity, hypopharynx, oropharynx, nasopharynx, paranasal sinuses, or larynx were treated using hyperfractionation (A-3 protocol) or accelerated fractionation (A-4 protocol) with chemotherapy. Amifostine was administered 15 to 30 minutes preradiation, at a dose of 500 mg/day in both protocols. It was given as an infusion over 5 to 7 minutes (A-3 protocol) or subcutaneously (A-4 protocol). Data regarding PEG placement and removal were collected prospectively. Results. Thirty-five evaluable A-3 protocol patients, 14 evaluable A-4 protocol patients, and 6 patients treated per A-4 protocol guidelines, but without amifostine as they refused the medication, were included in the analysis. Pretreatment characteristics, such as sex, age, race, T classification, N classification, American Joint Committee on Cancer (AJCC) stage, were compared between the 2 groups of patients. The only significant difference between the 2 groups was AJCC stage. Thirty-five A-3 patients and 20 A-4 patients had overall survivals of 88% versus 80%, 82% versus 75%, and 66% versus 67.5% at 1, 2, and 3 years, respectively (p = .958). With regard to PEG dependence, no significant differences were seen between the 2 groups at 6, 12, or 18 months. Conclusion. PEG dependence was not significantly different between the 2 study groups. Type of altered fractionation scheme may not influence PEG dependence in patients treated with similar protocols. Future randomized studies are needed to confirm these findings.
| Original language | English |
|---|---|
| Pages (from-to) | 944-948 |
| Number of pages | 5 |
| Journal | Head and Neck |
| Volume | 31 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2009 |
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Keywords
- Accelerated-concomitant boost radiation
- Head and neck cancer
- Hyperfractionated radiation
- PEG tube
ASJC Scopus subject areas
- Otorhinolaryngology
Cite this
Radiation technique influence on percutaneous endoscopic gastrostomy tube dependence : Comparison between two radiation schemes. / Hatoum, Georges F.; Abitbol, Andre; Elattar, Inas; Lewin, Alan; Troner, Michael; Kronberg, Frank; Raez, Luis E.; Weed, Donald; Abdel-Wahab, May.
In: Head and Neck, Vol. 31, No. 7, 01.07.2009, p. 944-948.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Radiation technique influence on percutaneous endoscopic gastrostomy tube dependence
T2 - Comparison between two radiation schemes
AU - Hatoum, Georges F.
AU - Abitbol, Andre
AU - Elattar, Inas
AU - Lewin, Alan
AU - Troner, Michael
AU - Kronberg, Frank
AU - Raez, Luis E.
AU - Weed, Donald
AU - Abdel-Wahab, May
PY - 2009/7/1
Y1 - 2009/7/1
N2 - Background. Our aim was to determine whether percutaneous endoscopic gastrostomy (PEG) dependence was significantly different between 2 prospective trials with different radiation fractionation schemes. Methods. Stage III or IV locally advanced head and neck squamous cell carcinomas arising from the oral cavity, hypopharynx, oropharynx, nasopharynx, paranasal sinuses, or larynx were treated using hyperfractionation (A-3 protocol) or accelerated fractionation (A-4 protocol) with chemotherapy. Amifostine was administered 15 to 30 minutes preradiation, at a dose of 500 mg/day in both protocols. It was given as an infusion over 5 to 7 minutes (A-3 protocol) or subcutaneously (A-4 protocol). Data regarding PEG placement and removal were collected prospectively. Results. Thirty-five evaluable A-3 protocol patients, 14 evaluable A-4 protocol patients, and 6 patients treated per A-4 protocol guidelines, but without amifostine as they refused the medication, were included in the analysis. Pretreatment characteristics, such as sex, age, race, T classification, N classification, American Joint Committee on Cancer (AJCC) stage, were compared between the 2 groups of patients. The only significant difference between the 2 groups was AJCC stage. Thirty-five A-3 patients and 20 A-4 patients had overall survivals of 88% versus 80%, 82% versus 75%, and 66% versus 67.5% at 1, 2, and 3 years, respectively (p = .958). With regard to PEG dependence, no significant differences were seen between the 2 groups at 6, 12, or 18 months. Conclusion. PEG dependence was not significantly different between the 2 study groups. Type of altered fractionation scheme may not influence PEG dependence in patients treated with similar protocols. Future randomized studies are needed to confirm these findings.
AB - Background. Our aim was to determine whether percutaneous endoscopic gastrostomy (PEG) dependence was significantly different between 2 prospective trials with different radiation fractionation schemes. Methods. Stage III or IV locally advanced head and neck squamous cell carcinomas arising from the oral cavity, hypopharynx, oropharynx, nasopharynx, paranasal sinuses, or larynx were treated using hyperfractionation (A-3 protocol) or accelerated fractionation (A-4 protocol) with chemotherapy. Amifostine was administered 15 to 30 minutes preradiation, at a dose of 500 mg/day in both protocols. It was given as an infusion over 5 to 7 minutes (A-3 protocol) or subcutaneously (A-4 protocol). Data regarding PEG placement and removal were collected prospectively. Results. Thirty-five evaluable A-3 protocol patients, 14 evaluable A-4 protocol patients, and 6 patients treated per A-4 protocol guidelines, but without amifostine as they refused the medication, were included in the analysis. Pretreatment characteristics, such as sex, age, race, T classification, N classification, American Joint Committee on Cancer (AJCC) stage, were compared between the 2 groups of patients. The only significant difference between the 2 groups was AJCC stage. Thirty-five A-3 patients and 20 A-4 patients had overall survivals of 88% versus 80%, 82% versus 75%, and 66% versus 67.5% at 1, 2, and 3 years, respectively (p = .958). With regard to PEG dependence, no significant differences were seen between the 2 groups at 6, 12, or 18 months. Conclusion. PEG dependence was not significantly different between the 2 study groups. Type of altered fractionation scheme may not influence PEG dependence in patients treated with similar protocols. Future randomized studies are needed to confirm these findings.
KW - Accelerated-concomitant boost radiation
KW - Head and neck cancer
KW - Hyperfractionated radiation
KW - PEG tube
UR - http://www.scopus.com/inward/record.url?scp=67650470940&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=67650470940&partnerID=8YFLogxK
U2 - 10.1002/hed.21056
DO - 10.1002/hed.21056
M3 - Article
C2 - 19309724
AN - SCOPUS:67650470940
VL - 31
SP - 944
EP - 948
JO - Head and Neck
JF - Head and Neck
SN - 1043-3074
IS - 7
ER -