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AbstractAbstract
[en] Results of a retrospective study at the University of Wuerzburg: Patients and methods: In a retrospective study the factors of influence on the locoregional control, the overall survival and the disease free survival of 106 patients with histological approved oropharyngeal cancer were tested with uni- and multivariate analysis. The median age at the date of the primary diagnosis was 55 years. A median follow up surveillance of 36 months could be achieved (between 5 to 126 months). In 18 cases (17%) the primary tumor could be removed in sano (safety margin >3mm). In 34 cases (32%) were detected close resection margins (<3mm) and in 54 cases the resection margins were not free of tumor cells (R1 resection). Patients, who were treated with chemotherapy, because of the increased recurrency risk, were 24% of the patient database. The concept of medical treatment: The tumorbed of the primary tumor and the cervical lymphatic drain received a radiation dose of 56 Gy (2 Gy/ treatment, 5 fractions a week). Patients with R0 resections received doses from 56 to 60 Gy. Patients with close resections margins received a higher dose of 60 to 66 Gy at the tumorbed and patients with R1 resections were treated with a boost up to 66 to 70 Gy. Patients with UICC 4 status with an increased recurrency risk received an additional chemotherapy with cisplatin (40mg/m"2 a week) in 1 to 4 cycles as well a boost of the tumorbed up to 66 to 70 Gy. In the univariate analysis with the Kaplan-Maier Plat method following factors of influence were detected: tumor status (p-value 0,003), lymph node status (p-value 0,048), chemotherapy (p-value 0,047), second tumor (p-value 0,003) and the overall tumor volume (p-value 0,000). Results of the multivariate analysis In the Cox regression analysis the tumor status and the development of a second tumor were detected as factors of influence of the 5 year overall survival rate and the 5 year disease free survival survival rate. Regarding to the overall survival rate for the tumor status was detected a statistical significance of 0,015 and regarding the disease free survival was detected a significance of 0,025. The factor of influence of the second tumor had a significance for the overall survival of 0,015 and a significance regarding the disease free survival of 0,025. Conclusion: With the concept of medical treatment there could be achieved an improvement of the 5 year overall survival and the 5 year disease free survival. Patients with close resection margins had throughout better results as patients with a R0 resection. The consequence of those results should be an adjustment of the present concept of medical treatment of the R0 patients to the concept of patients with close resection margins. Patients who received a simultaneous radiochemotherapy, because of the increased risk of recurrence, the present concept of medical treatment effected an adjustment of the 5 year overall survival rate to patients without an increased risk of recurrence. There was no statistical significance in the multivariate analysis at the overall survival as well as at the disease free survival (overall survival p-value 0,064, disease free survival p-value 0,085).
Original Title
Operation und adjuvante Bestrahlung bei Oropharynx- und Mundhoehlenkarzinomen. Klinische Ergebnisse an der Universitaet Wuerzburg aus den Jahren 1998-2010
Primary Subject
Source
20 Sep 2016; 66 p; Available from: https://opus.bibliothek.uni-wuerzburg.de/files/13942/Rosenheim_Eva_Oropharynxkar zinome.pdf; Diss.
Record Type
Miscellaneous
Literature Type
Thesis/Dissertation; Numerical Data
Country of publication
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