ACUTE TOXICITY PROFILE AND COMPLIANCE TO ACCELERATED RADIOTHERAPY PLUS CARBOGEN AND NICOTINAMIDE FOR CLINICAL STAGE T2-4 LARYNGEAL CANCER: RESULTS OF A PHASE III RANDOMIZED TRIAL

作者：Janssens Geert O^*; Terhaard Chris H; Doornaert Patricia A; Bijl Hendrik P; van den Ende Piet; Chin Alim; Pop Lucas A; Kaanders Johannes H

来源：International Journal of Radiation Oncology, Biology, Physics, 2012, 82(2): 532-538.

DOI：10.1016/j.ijrobp.2010.11.045

• ARCON
• Acute toxicity
• Laryngeal cancer

Purpose: To report the acute toxicity profile and compliance from a randomized Phase III trial comparing accelerated radiotherapy (AR) with accelerated radiotherapy plus carbogen and nicotinamide (ARCON) in laryngeal cancer. %26lt;br%26gt;Methods and Materials: From April 2001 to February 2008, 345 patients with cT2-4 squamous cell laryngeal cancer were randomized to AR (n = 174) and ARCON (ii = 171). Acute toxicity was scored weekly until Week 8 and every 2-4 weeks thereafter. Compliance to carbogen and nicotinamide was reported. %26lt;br%26gt;Results: Between both treatment arms (AR vs. ARCON) no statistically significant difference was observed for incidence of acute skin reactions (moist desquamation: 56% vs. 58%,p = 0.80), acute mucosal reactions (confluent mucositis: 79% vs. 85 %, p = 0.14), and symptoms related to acute mucositis (severe pain on swallowing: 53% vs. 58%,p = 0.37; nasogastric tube feeding: 28% vs. 28%,p = 0.98; narcotic medicines required: 58% vs. 58 %,p = 0.97). There was a statistically significant difference in median duration of confluent mucositis in favor of AR (2.0 vs 3.0 weeks, p = 0.01). There was full compliance with carbogen breathing and nicotinamide in 86% and 80% of the patients, with discontinuation in 6% and 12%, respectively. Adjustment of antiemesis prophylaxis was needed in 42% of patients. %26lt;br%26gt;Conclusion: With the exception of a slight increase in median duration of acute confluent mucositis, the present data reveal a similar acute toxicity profile between both regimens and a good compliance with ARCON for clinical stage T2-4 laryngeal cancers. Treatment outcome and late morbidity will determine the real therapeutic benefit.

• 出版日期2012-2-1