| Joined: Feb 2004 Posts: 598 "Above & Beyond" Member (500+ posts) | "Above & Beyond" Member (500+ posts) Joined: Feb 2004 Posts: 598 | I question the essential validity of the study, due to the fact that a different patient population (older, poorer performance status) was used for the weekly dose, and younger, better performing patients were used for the 21 day regimen. A more valid study would have been to use similar patient populations in each treatment modality, then compare.
My CCC uses the weekly regimen as its primary therapeutic methodology, and has had good results.
I am also curious about the low (50% and 40%) Complete Response Rates. That is significantly below what is acheived at most CCC's these days, based upon my reading. Would be interesting to see what the TMN and location characteristics for the test population.
Also tough to draw too many broad conclusions, since test population was small. Jeff SCC Right BOT Dx 3/28/2007 T2N2a M0G1,Stage IVa Bilateral Neck Dissection 4/11/2007 39 x IMRT, 8 x Cisplatin Ended 7/11/07 Complete response to treatment so far!!
| | | | Joined: May 2007 Posts: 666 "Above & Beyond" Member (500+ posts) | "Above & Beyond" Member (500+ posts) Joined: May 2007 Posts: 666 | I concur, but this is all that I came across. A study with a more comparable population (eating, drinking, smoking, health care etc) would be better. What is needed is an "identical" set of patients for the 3 vs 7 treatments. .... It would seem reasonable that the younger group can tolerate a harsher treatment better than the older group. If the outcome and adverse effects are similar then this favors the weekly regimen (in my mind). Perhaps we are splitting hairs here. The important thing may just be that one HAS concurrent chemo with IMRT. I will see my MO (young guy) this Saturday and will query him regarding and his take on this. This one deals with recurrent HNC http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2621229They strongly advocate radiation +/- chemo to reduce rHNC. M
Partial glossectomy (25%) anterior tongue. 4/6/07/. IMRT start @5/24/07 (3x) Erbitux start/end@ 5/24/07. IMRT wider field (30x) start 6/5/07. Weekly cisplatin (2x30mg/m2), then weekly carbo- (5x180mg/m2). End of Tx 19 July 07.
| | | | Joined: Sep 2006 Posts: 8,311 Senior Patient Advocate Patient Advocate (old timer, 2000 posts) | Senior Patient Advocate Patient Advocate (old timer, 2000 posts) Joined: Sep 2006 Posts: 8,311 | Markus said above....They strongly advocate radiation +/- chemo to reduce rHNC.
That's an understatement... as they recommend postoperative radiation and chemo if the expected recurrence rate is only 10%, pretty much regardless of initial tumor size or other Staging factors so unless I'm missing something, that's pretty much saying almost everyone with HN cancer should get concurrent rad/chemo.
David
Age 58 at Dx, HPV16+ SCC, Stage IV BOT+2 nodes, non smoker, casual drinker, exercise nut, Cisplatin x 3 & concurrent IMRT x 35,(70 Gy), no surgery, no Peg, Tx at Moffitt over Aug 06. Jun 07, back to riding my bike 100 miles a wk. Now doing 12 Spin classes and 60 outdoor miles per wk. Nov 13 completed Hilly Century ride for Cancer, 104 miles, 1st Place in my age group. Apr 2014 & 15, Spun for 9 straight hrs to raise $$ for YMCA's Livestrong Program. Certified Spin Instructor Jun 2014.
| | | | Joined: May 2007 Posts: 666 "Above & Beyond" Member (500+ posts) | "Above & Beyond" Member (500+ posts) Joined: May 2007 Posts: 666 | ah, but David this is what they said:
Conclusions: Gabriela Studer,1 Klaus W Graetz,2 and Christoph Glanzmann, Radiat Oncol. 2008; 3: 43.
re rHNC "A low salvage rate of only ~50% at 2 years was found. Calculated numbers of patients needed to treat with postoperative radiation after initial surgery, in order to avoid recurrence and tumor-specific death, suggest a rather generous use of adjuvant irradiation, usually with simultaneous chemotherapy."
.... while the results are pretty convincing, it will take more (and independent) confirmation (also in the US).
M
quite often you find a cautious tone (i.e. suggest) in a scientific article. Unfortunately, the cranks do not stay away from absolutes.
Last edited by Markus; 07-27-2009 10:05 PM.
Partial glossectomy (25%) anterior tongue. 4/6/07/. IMRT start @5/24/07 (3x) Erbitux start/end@ 5/24/07. IMRT wider field (30x) start 6/5/07. Weekly cisplatin (2x30mg/m2), then weekly carbo- (5x180mg/m2). End of Tx 19 July 07.
| | | | Joined: Jun 2009 Posts: 440 Platinum Member (300+ posts) | OP Platinum Member (300+ posts) Joined: Jun 2009 Posts: 440 | Thanks Marcus and David, didn't even think about the chemo schedule, but for some reason I want to say it would be weekly. I would love to hear what your MO says Marcus.
Dx 3/27/09 @ 28 years old with High Grade MEC T4N2M0 Elizabeth, 33, mother of 3 girls (4,7, &8yrs old) 3 rds of chemo(Carbo/Taxol) Rt Mandibulectomy, rt fibular flap,& rt ND with trach, picc,& g-tube. 30 rds of rads with weekly cisplatin SCANS ALL CLEAR! OCF Regional Coordinator of San Antonio Walk
| | | | Joined: Apr 2009 Posts: 104 Senior Member (100+ posts) | Senior Member (100+ posts) Joined: Apr 2009 Posts: 104 | John just completed radiation, after surgery to remove the primary tumor (right tonsillar region though he had a tonsillectomy as a kid) and the three cancerous lymph nodes (plus a number of others that were matted together but turned out to be noncancerous). The ENT and RO decided on surgery followed by radiation vs radiation and chemo, so now we'll see; he finished up the treatments on the 14th... best of wishes for your situation
GM, for John who has SCC Rt tonsil with 3+ nodes, Stage T1 N2b MX; surgery 04/09; Rad X 33 completed 7/14/09...f/u imaging and scopes looking good as of Feb 2011
| | |
Forums23 Topics18,168 Posts196,927 Members13,104 | Most Online458 Jan 16th, 2020 | | | |