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    Curative-intent radiotherapy for squamous cell carcinoma of the head and neck in sri lanka: the impact of radiotherapy technique on survival

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    Authors
    Rupasinghe, T.
    Silva, D. C.
    Balawardena, J.
    Perera, K.
    Gunasekera, D.
    Weerasinghe, S.
    Jeyakumaran, N.
    Abeysinghe, P.
    Skandarajah, T.
    Choudhury, Ananya
    Joseph, N.
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    Affiliation
    National Cancer Institute, Maharagama, Sri Lanka; Sri Lanka Cancer Research Group, Sri Lanka College of Oncologists, Mahargama, Sri Lanka
    Issue Date
    2021
    
    Metadata
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    Abstract
    Aims: We conducted a retrospective analysis of patients with squamous cell carcinoma of the head and neck (SCCHN) treated with curative-intent radiotherapy at the National Cancer Institute of Sri Lanka to determine the impact of the treatment technique on disease-free survival (DFS). Materials and methods: SCCHN patients treated with radical radiotherapy or adjuvant postoperative radiotherapy from 2016 to 2017 were included in the study. Data on the following variables were collected by reviewing clinical and radiotherapy treatment records: age, gender, tumour site, stage, time to delivery of radiotherapy, use of neoadjuvant chemotherapy, use of concurrent radiosensitising chemotherapy and treatment technique. DFS, defined as the time to death, tumour recurrence or loss to follow-up, was the primary end point and outcomes were compared between patients treated with intensity-modulated radiotherapy (IMRT) in linear accelerators and those treated with conventional radiotherapy in cobalt teletherapy units. Univariate and multivariate analyses were carried out on known prognostic variables. Results: In total, 408 patients were included in the study, with 138 (34%) being treated with IMRT in the linear accelerator. More than 75% of patients were of stage III or IV at diagnosis. The 2-year DFS of the whole cohort was 25% (95% confidence interval 21-30%). Patients treated with IMRT in the linear accelerator had a superior DFS in comparison with those treated with conventional radiotherapy in the cobalt teletherapy units (P < 0.001, hazard ratio 0.64, 95% confidence interval 0.5-0.82). Higher stage, cobalt treatment and use of neoadjuvant chemotherapy were adversely associated with DFS on multivariate analysis. Conclusion: A large proportion of patients with SCCHN treated with curative-intent radiotherapy in Sri Lanka had locally advanced disease and DFS was superior in patients treated with IMRT in the linear accelerator.
    Citation
    Rupasinghe T, Silva DC, Balawardena J, Perera K, Gunasekera D, Weerasinghe S, et al. Curative-Intent Radiotherapy for Squamous Cell Carcinoma of the Head and Neck in Sri Lanka: The Impact of Radiotherapy Technique on Survival. Clinical Oncology. Elsevier BV; 2021.
    Journal
    Clinical Oncology
    URI
    http://hdl.handle.net/10541/624683
    DOI
    10.1016/j.clon.2021.09.017
    PubMed ID
    34642066
    Additional Links
    https://dx.doi.org/10.1016/j.clon.2021.09.017
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.clon.2021.09.017
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