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Rene C Leemans - One of the best experts on this subject based on the ideXlab platform.
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comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and Oropharynx with microvascular soft tissue reconstruction
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2003Co-Authors: Pepijn A. Borggreven, Dirk J. Kuik, Remco De Bree, Jasper J Quak, Gordon B Snow, Rene C LeemansAbstract:BACKGROUND: Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients. METHODS: One hundred patients with an oral/Oropharynx Carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE-27) test. Postoperative complications were scored according to their severity. RESULTS: Comorbidity score ACE-27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE-27 grade > or =2 was a strong predictor for complications (p or =2. It may be concluded from these results that prevention of complications should focus on comorbidities.
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comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and Oropharynx with microvascular soft tissue reconstruction
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2003Co-Authors: Pepijn A. Borggreven, Dirk J. Kuik, Remco De Bree, Jasper J Quak, Gordon B Snow, Rene C LeemansAbstract:Background. Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients. Methods. One hundred patients with an oral/Oropharynx Carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE-27) test. Postoperative complications were scored according to their severity. Results. Comorbidity score ACE-27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE-27 grade ≥2 was a strong predictor for complications (p <.001). There were no other predictors for postoperative complications. Conclusions. Comorbidity is of great importance for prediction of postoperative complications in head and neck cancer patients, especially an ACE-27 grade ≥2. It may be concluded from these results that prevention of complications should focus on comorbidities.
Pepijn A. Borggreven - One of the best experts on this subject based on the ideXlab platform.
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comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and Oropharynx with microvascular soft tissue reconstruction
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2003Co-Authors: Pepijn A. Borggreven, Dirk J. Kuik, Remco De Bree, Jasper J Quak, Gordon B Snow, Rene C LeemansAbstract:BACKGROUND: Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients. METHODS: One hundred patients with an oral/Oropharynx Carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE-27) test. Postoperative complications were scored according to their severity. RESULTS: Comorbidity score ACE-27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE-27 grade > or =2 was a strong predictor for complications (p or =2. It may be concluded from these results that prevention of complications should focus on comorbidities.
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comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and Oropharynx with microvascular soft tissue reconstruction
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2003Co-Authors: Pepijn A. Borggreven, Dirk J. Kuik, Remco De Bree, Jasper J Quak, Gordon B Snow, Rene C LeemansAbstract:Background. Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients. Methods. One hundred patients with an oral/Oropharynx Carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE-27) test. Postoperative complications were scored according to their severity. Results. Comorbidity score ACE-27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE-27 grade ≥2 was a strong predictor for complications (p <.001). There were no other predictors for postoperative complications. Conclusions. Comorbidity is of great importance for prediction of postoperative complications in head and neck cancer patients, especially an ACE-27 grade ≥2. It may be concluded from these results that prevention of complications should focus on comorbidities.
G Calais - One of the best experts on this subject based on the ideXlab platform.
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radiotherapy with concomitant weekly docetaxel for stages iii iv Oropharynx Carcinoma results of the 98 02 gortec phase ii trial
International Journal of Radiation Oncology Biology Physics, 2004Co-Authors: G Calais, E Bardet, C Sire, M Alfonsi, Jean Bourhis, B Rhein, Jacques Tortochaux, Yooye Tao Kong Man, H Auvray, P GaraudAbstract:Abstract Purpose We designed a prospective Phase II clinical trial to evaluate the addition of weekly chemotherapy using Docetaxel during standard radiation therapy in patients with Stages III and IV Oropharynx Carcinoma. Methods A total of 63 patients have been entered in a Phase II multicenter trial. Radiotherapy delivered, with conventional fractionation, 70 Gy in 35 fractions. Patients received during the period of radiotherapy seven cycles of Docetaxel (20 mg/m 2 each week). Results Radiotherapy compliance was good in respect to total dose, treatment duration, and treatment interruption. The rate of Grade 3 and 4 mucositis was 84%. Grade 3 and 4 skin toxicity occurred in 53% of the patients. Hematologic toxicity was infrequent, with only a 5% rate of Grade 3 or 4 neutropenia. Three-year overall actuarial survival and disease-free survival rates were, respectively, 47% (95% CI=39–68%) and 39% (95% CI=30–57%). The local and regional control rate was 64%. Conclusion The adjunction of weekly Docetaxel to conventional radiotherapy is feasible. Mucositis and skin toxicity were the major acute toxic effects. Therapeutic results were similar to those observed with concomitant chemotherapy using platinum and/or 5-FU. Further trials using Docetaxel in combination with other cytotoxic agents are needed.
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final results of the 94 01 french head and neck oncology and radiotherapy group randomized trial comparing radiotherapy alone with concomitant radiochemotherapy in advanced stage Oropharynx Carcinoma
Journal of Clinical Oncology, 2004Co-Authors: F Denis, E Bardet, C Sire, M Alfonsi, B Rhein, P Garaud, T Germain, P Bergerot, J Tortochaux, G CalaisAbstract:Purpose We report the 5-year survival and late toxicity results of a randomized clinical trial, which showed a 3-year improvement in overall survival and locoregional control of stage III or IV Oropharynx Carcinoma, using concomitant radiochemotherapy (arm B), compared with standard radiotherapy (arm A). Patients and Methods A total of 226 patients were entered onto a phase III multicenter randomized trial comparing radiotherapy alone (70 Gy in 35 fractions; arm A) with concomitant radiochemotherapy (70 Gy in 35 fractions with three cycles of a 4-day regimen comprising carboplatin and fluorouracil; arm B). Prognostic factors were evaluated by univariate and multivariate analysis. Five-year late toxicity was evaluated using National Cancer Institute Common Toxicity Criteria for neurological toxicity, hearing, taste, mandibula, and teeth damage, and Radiation Therapy Oncology Group toxicity criteria for skin, salivary gland, and mucosa. Results Five-year overall survival, specific disease-free survival, and...
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randomized trial of radiation therapy versus concomitant chemotherapy and radiation therapy for advanced stage Oropharynx Carcinoma
Journal of the National Cancer Institute, 1999Co-Authors: G Calais, E Bardet, C Sire, M Alfonsi, B Rhein, T Germain, P Bergerot, J Tortochaux, Patrick Oudinot, Philippe BertrandAbstract:Background We designed a randomized clinical trial to test whether the addition of three cycles of chemotherapy during standard radiation therapy would improve disease-free survival in patients with stages III and IV (i.e., advanced Oropharynx Carcinoma). Methods A total of 226 patients have been entered in a phase III multicenter, randomized trial comparing radiotherapy alone (arm A) with radiotherapy with concomitant chemotherapy (arm B). Radiotherapy was identical in the two arms, delivering, with conventional fractionation, 70 Gy in 35 fractions. In arm B, patients received during the period of radiotherapy three cycles of a 4-day regimen containing carboplatin (70 mg/m(2) per day) and 5-fluorouracil (600 mg/m(2) per day) by continuous infusion. The two arms were equally balanced with regard to age, sex, stage, performance status, histology, and primary tumor site. Results Radiotherapy compliance was similar in the two arms with respect to total dose, treatment duration, and treatment interruption. The rate of grades 3 and 4 mucositis was statistically significantly higher in arm B (71%; 95% confidence interval [CI] = 54%-85%) than in arm A (39%; 95% CI = 29%-56%). Skin toxicity was not different between the two arms. Hematologic toxicity was higher in arm B as measured by neutrophil count and hemoglobin level. Three-year overall actuarial survival and disease-free survival rates were, respectively, 51% (95% CI = 39%-68%) versus 31% (95% CI = 18%-49%) and 42% (95% CI = 30%-57%) versus 20% (95% CI = 10%-33%) for patients treated with combined modality versus radiation therapy alone (P =.02 and.04, respectively). The locoregional control rate was improved in arm B (66%; 95% CI = 51%-78%) versus arm A (42%; 95% CI = 31%-56%). Conclusion The statistically significant improvement in overall survival that was obtained supports the use of concomitant chemotherapy as an adjunct to radiotherapy in the management of Carcinoma of the Oropharynx.
Gordon B Snow - One of the best experts on this subject based on the ideXlab platform.
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comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and Oropharynx with microvascular soft tissue reconstruction
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2003Co-Authors: Pepijn A. Borggreven, Dirk J. Kuik, Remco De Bree, Jasper J Quak, Gordon B Snow, Rene C LeemansAbstract:BACKGROUND: Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients. METHODS: One hundred patients with an oral/Oropharynx Carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE-27) test. Postoperative complications were scored according to their severity. RESULTS: Comorbidity score ACE-27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE-27 grade > or =2 was a strong predictor for complications (p or =2. It may be concluded from these results that prevention of complications should focus on comorbidities.
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comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and Oropharynx with microvascular soft tissue reconstruction
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2003Co-Authors: Pepijn A. Borggreven, Dirk J. Kuik, Remco De Bree, Jasper J Quak, Gordon B Snow, Rene C LeemansAbstract:Background. Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients. Methods. One hundred patients with an oral/Oropharynx Carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE-27) test. Postoperative complications were scored according to their severity. Results. Comorbidity score ACE-27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE-27 grade ≥2 was a strong predictor for complications (p <.001). There were no other predictors for postoperative complications. Conclusions. Comorbidity is of great importance for prediction of postoperative complications in head and neck cancer patients, especially an ACE-27 grade ≥2. It may be concluded from these results that prevention of complications should focus on comorbidities.
Jasper J Quak - One of the best experts on this subject based on the ideXlab platform.
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comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and Oropharynx with microvascular soft tissue reconstruction
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2003Co-Authors: Pepijn A. Borggreven, Dirk J. Kuik, Remco De Bree, Jasper J Quak, Gordon B Snow, Rene C LeemansAbstract:BACKGROUND: Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients. METHODS: One hundred patients with an oral/Oropharynx Carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE-27) test. Postoperative complications were scored according to their severity. RESULTS: Comorbidity score ACE-27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE-27 grade > or =2 was a strong predictor for complications (p or =2. It may be concluded from these results that prevention of complications should focus on comorbidities.
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comorbid condition as a prognostic factor for complications in major surgery of the oral cavity and Oropharynx with microvascular soft tissue reconstruction
Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2003Co-Authors: Pepijn A. Borggreven, Dirk J. Kuik, Remco De Bree, Jasper J Quak, Gordon B Snow, Rene C LeemansAbstract:Background. Identification of factors, especially comorbidity, that affect the incidence and severity of complications in head and neck cancer patients. Methods. One hundred patients with an oral/Oropharynx Carcinoma undergoing composite resection and microvascular soft tissue transfer were analyzed. Patient data and tumor and treatment factors were recorded. Comorbidity was graded by an Adult Comorbidity Evaluation 27 (ACE-27) test. Postoperative complications were scored according to their severity. Results. Comorbidity score ACE-27 grade 2 or higher was present in 47% of patients, whereas 33% had a clinically important complication develop. A comorbidity score of ACE-27 grade ≥2 was a strong predictor for complications (p <.001). There were no other predictors for postoperative complications. Conclusions. Comorbidity is of great importance for prediction of postoperative complications in head and neck cancer patients, especially an ACE-27 grade ≥2. It may be concluded from these results that prevention of complications should focus on comorbidities.