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Clinical Features and the Risk Factors of Distant Metastasis in Locally Advanced Advanced Head and Neck Cancer Patients after Induction Chemotherapy Followed Locoregional Control Therapy  

Lee, Hye-Won (Department of Internal Medicine, Pusan National University School of Medicine)
Baek, Dong-Hoon (Department of Internal Medicine, Pusan National University School of Medicine)
Lee, Kyung-Nam (Department of Internal Medicine, Pusan National University School of Medicine)
Cho, Eun-Jung (Department of Internal Medicine, Pusan National University School of Medicine)
Kim, Hyo-Jeong (Department of Internal Medicine, Pusan National University School of Medicine)
Seol, Young-Mi (Department of Internal Medicine, Pusan National University School of Medicine)
Song, Moo-Kon (Department of Internal Medicine, Pusan National University School of Medicine)
Choi, Young-Jin (Department of Internal Medicine, Pusan National University School of Medicine)
Shin, Ho-Jin (Department of Internal Medicine, Pusan National University School of Medicine)
Chung, Joo-Seop (Department of Internal Medicine, Pusan National University School of Medicine)
Cho, Goon-Jae (Department of Internal Medicine, Pusan National University School of Medicine)
Publication Information
Korean Journal of Head & Neck Oncology / v.27, no.2, 2011 , pp. 177-182 More about this Journal
Abstract
Backgrounds : Head and neck cancer is one of the most prevalent cancers in the world. It tends to remain localized at the primary site and regional lymph nodes, but if distant metastasis occurs, it has a poor prognosis. This study was performed to evaluate the prevalence of distant metastasis and to determine the risk factor in locally advanced head and neck cancer after induction chemotherapy followed locoregional control therapy. Methods : A retrospective review was performed in 420 patients with locally advanced head and neck cancer who treated with induction chemotherapy followed locoregional control therapy from January 2001 to December 2010. Among them, 31 patients who had distant metastasis as first relapse within 2 years after termination of therapy were analyzed for clinical features and the risk factors of distant metastasis. Results : The overall incidence of distant metastasis was 7.3%. The bone, lung, and liver were the most frequent metastatic organs. In univariate analysis, nodal stage, nasopharyngeal cancer, laryngeal cancer, G3/G4 neutropenia during induction chemotherapy, and concurrent chemoradiotherapy were the influencing factors for distant metastasis. In multivariate analysis, advanced N stage and nasopharynx were the risk factors of distant metastasis, and grade 3/4 neutropenia during induction chemotherapy was considered to decrease distant metastasis. Conclusion : This study suggests that the advanced N stage is the risk factor of distant metastasis and Grade 3/4 neutropenia during induction chemotherapy can be beneficial against distant metastasis in locally advanced head and neck cancer patients treated with induction chemotherapy followed locoregional control therapy.
Keywords
Distant metastasis; Head and neck; Neutropenia; Nodal stage;
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1 Yamamoto N, Mizoe J, Numasawa H, Tsujii H, Shibahara T, Noma H. Allelic loss on chromosomes 2q, 3p and 21q: possibly a poor prognostic factor in oral squamous cell carcinoma. Oral Oncol 2003;39:796-805.   DOI   ScienceOn
2 Jacobs C, Goffinet DR, Goffinet L, Kohler M, Fee WE. Chemotherapy as a substitute for surgery in the treatment of advanced resectable head and neck cancer. A report from the northern California oncology group. Cancer. 1987;60(6):1178-1183.   DOI   ScienceOn
3 Crile GW. Carcinoma of the jaws, tongue, cheek, and lips. Surg Gynecol Obstet. 1923;6:159-184.
4 Betka J. Distant metastases from lip and oral cavity cancer. ORL. 2001;63:217-221.   DOI   ScienceOn
5 Doweck I, Robbins KT, Vieira F. Analysis of risk factors predictive of distant failure after targeted chemoradiation for advanced head and neck cancer. Arch Otolaryngol Head Neck Surg. 2001;127:1315-1318.   DOI
6 Kim BK, Jeong JU, Park CI, Rha KS, Nam BH. A clinical study of distant metastases in head and neck cancer. Korean J Otolaryngol. 1998;41(7):913-917.
7 Merino OR, Lindberg RD, Fletcher GH. An analysis of distant metastases from squamous cell carcinoma of the upper respiratory and digestive tracts. Cancer. 1977;40:145-151.   DOI   ScienceOn
8 Alvi A, Jaohson KT. Development of distant metastasis after treatment of advanced-stage head and neck cancer. Head Neck. 1997;19:500-505.   DOI   ScienceOn
9 Garavello W, Ciardo A, Spreafico R, Gaini RM. Risk factors for distant metastases in head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 2006;132:762-766.   DOI   ScienceOn
10 Leemans CR, Tiwari R, Nauta JJ, van der Waal I, Snow GB. Regional lymph node involvement and its significance in the development in head and neck carcinoma. Cancer. 1993;71:452-456.   DOI   ScienceOn
11 Colevas AD, Norris CM, Tishler RB, Lamb CC, Fried MP, Go-guen LA, et al. Phase I/II trial of outpatient docetaxel, cisplatin, 5-fluorouracil, leucovorin(opTPFL) as induction for squamous cell carcinoma of the head and neck(SCCHN). Am J Clin Oncol. 2002;25:153-159.   DOI   ScienceOn
12 Vokes EE, Kies MS, Rosen FR, Humerickhouse RA, Stenson K, Brockstein BE, et al. Induction chemotherapy(IndCT) followed by concomitant chemoradiotherapy(CXRT) forstage IV head and neck cancer(HNC): an attempt at locoregional and systemic tumor control. Proc Am Soc Clin Oncol. 2000;19:1653.
13 Pignon JP, Bourhis J, Domenge C, Designe L. Chemotherapy ad-ded to locoregional treatment for head and neck squamous cell carcinoma: three metaanalyses of updated individual data. Lancet. 2000;355:949-955.
14 Poikonen P, Saarto T, Lundin J, Joensuu H, Blomqvist C. Leucocyte nadir as a marker for chemotherapy efficacy in node po-sitive breast cancer treated with adjuvant CMF. Br J Cancer. 1999;80:1763-1766.   DOI
15 Kohne CH, Cunningham D, Di CF, Glimelius B, Blijham G, Aranda E, et al. Clinical determinants of survival in patients with 5-Fluorouracil-based treatment for metastatic colorectal cancer: results of a multivariate analysis of 3825 patients. Ann Oncol. 2002;13:308-317.   DOI   ScienceOn
16 Hsu LP, Chen PR. Distant metastases of head and neck squamous cell carcinomas? experience from Eastern Taiwan. Tzu Chi Med J. 2005;17:99-104.
17 Sham JST, Choy D, Chan FL, Cheung YK. Nasopharyngeal carcinoma: Pattern of skeletal metastases. Br J Radiol. 1990;63:202-205.   DOI   ScienceOn
18 Spector JG, Sessions DG, Haughey BH, Chao KS, Simpson J, El Mofty S, et al. Delayed regional metastases, distant metastases, and second primary malignancies in squamous cell carcinomas of the larynx and hypopharynx. Laryngoscope. 2001;111:1079-1087.   DOI   ScienceOn
19 Leon X, Quer M, Orus C, del Prado Venegas M, Lopez M. Distant metastases in head and neck cancer patients who achieved loco-regional control. Head Neck. 2000;22:680-686.   DOI   ScienceOn
20 Park BJ, Shin YS, Oh KK, Lee YS. Distant metastases in head and neck carcinoma. Korean J otolaryngol 1996;39:1016-1024.