PURPOSE: To evaluate the effectiveness and toxicity of curative (chemo)radiotherapy in patients with metastatic carcinoma to cervical lymph nodes from an unknown primary. METHODS: Retrospective study of 90 consecutive patients, treated with curative radiotherapy from 2003 to 2018 (median age 59 years; current/former smokers 76%) was conducted. The distribution of nodal staging was as follows: N1: 12%, N2a: 21%, N2b: 43%, N2c: 10%, N3: 13%. In 62% of patients, neck dissection was performed before radiotherapy. Concomitant chemotherapy was given to 64% of patients. RESULTS: The median follow-up of surviving patients was 86 months. The median total radiotherapy dose achieved was 70 Gy. The 5‐ and 10-year locoregional control were 84% in both cases, while 5‐ and 10-year distant control were 90% and 89%, respectively. A primary tumor in the head and neck area was detected in only 2 patients. No patient had an initial failure in the pharyngeal axis or contralateral cervical nodes. The 5‐ and 10-year overall survival were 55% and 42%, respectively. Severe early toxicity occurred in 71%; severe late toxicity in 33% of patients. Multivariate analysis demonstrated N‐status (hazard ratio [HR] 2.424; 95% confidence interval [CI] 1.121-5.241; p = 0.024) and comorbidity scores assessed by ACE-27 (Adult Comorbidity Evaluation; HR 3.058; 95% CI 1.489-6.281; p = 0.002) as two independent prognostic factors for overall survival. CONCLUSION: The results of our work study demonstrate the high effectiveness of curative (chemo)radiotherapy on the pharyngeal axis and bilateral cervical nodes with long-term locoregional and distant control in 3/4 of the treated patients. N‐status and comorbidity scores were shown as strong prognostic factors influencing overall survival.
- MeSH
- dospělí MeSH
- karcinom * patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfatické metastázy patologie MeSH
- lymfatické uzliny patologie MeSH
- nádory hlavy a krku * patologie MeSH
- nádory neznámé primární lokalizace * terapie patologie MeSH
- retrospektivní studie MeSH
- staging nádorů MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND/AIM: To evaluate the effectiveness of curative (chemo)radiotherapy in patients with nasopharyngeal carcinoma and to identify prognostic factors influencing treatment outcomes. PATIENTS AND METHODS: We conducted a retrospective study of 73 consecutive patients, treated with definitive (chemo)radiotherapy from 2002 to 2019 (median stage III/IV 78%). The median total dose of radiotherapy achieved was 70 Gy. Concomitant chemotherapy was given to 82% of patients. RESULTS: The five- and ten-year locoregional controls were 73% and 72%, respectively; the five- and ten-year distant controls were 93% and 93%, respectively. The five- and ten-year overall survival rates were 46% and 34%, respectively. A multivariate analysis identified age, smoking, and the initial response to treatment as the strongest prognostic factors in predicting survival. CONCLUSION: Smoking ≤5 years before starting curative (chemo)radiotherapy for nasopharyngeal carcinoma was shown to be an independent negative prognostic factor for overall survival with a four-fold higher risk of death compared to non-smokers.
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- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
- MeSH
- dietoterapie * metody MeSH
- kachexie etiologie terapie MeSH
- lidé MeSH
- nádory * dietoterapie komplikace MeSH
- nutriční podpora MeSH
- parenterální výživa MeSH
- potrava speciální MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
Východiska: Onkologické rány a rány jiné etiologie u onkologických pacientů jsou sice vzácnou, ale pro pacienta závažnou komplikací, která významným způsobem negativně ovlivňuje kvalitu jeho života. Preventivní a léčebné intervence, edukce zdravotníků a pacienta snižují riziko jejich výskytu nebo rozsah následků. Pracovní skupina autorů z odborných skupin (Sekce podpůrné léčby a péče České onkologické společnosti ČLS JEP, Česká společnost pro léčbu rány, Společnost radiační onkologie, biologie a fyziky ČLS JEP, Česká asociace sester) připravila doporučení vhodné péče. Komplexní přístup k léčbě onkologické rány vč. symptomatické léčby s ní spojených komplikací hojení, prevence, včasný záchyt, mezioborová spolupráce a edukace jsou zásadní v přístupu k řešení ran souvisejících s aplikací chemoterapie, radioterapie a onkologické léčby obecně. Správná volba přípravků lokální péče a možnost doplnění onkologické léčby jsou základem v péči o rány při exulceraci tumoru. Cíl: Základní doporučení pro prevenci a léčbu onkologických ran pro denní praxi na základě doporučení odborných společností, výstupů studií a odborné literatury, ověřené praxe a shody názorů členů autorské skupiny. Doporučené postupy přispívají k redukci rozvoje, tíže a následků onkologických a jiných ran onkologických pacientů.
Background: Oncology wounds and wounds of other etiology are rare but serious complications, which significantly impair patients‘ quality of life. Preventive and curative interventions and education of healthcare personnel and patients reduce the risk of either their occurrence or their impact and consequences. A working group of authors from professional groups (the Supportive Care Group of the Czech Society for Oncology, the Czech Society for Wound Healing, the Society for Radiation Oncology, Biology and Physics, and the Czech Nurses Association) prepared recommendations for care. A comprehensive approach to the treatment of oncological wounds, including symptomatic treatment of associated healing complications, prevention, early detection, interdisciplinary cooperation and education are essential to deal with wounds related to chemotherapy administration, radiotherapy and oncological treatment in general. The proper choice of local care products and the eventuality of active oncological treatment are important elements of care in ulcerating tumors. Purpose: A basic summary of recommended interventions to prevent and treat oncology wounds in daily practice, defined based on expert societies guidelines, trials and literature data, proven practice and on the consensus opinions of the author‘s group members. The recommended procedures contribute to the reduction of the development, severity and consequences of oncological wounds and wounds of other etiology in oncological patients.
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- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
