Treatment
MDT collaboration was operated in our hospital, which aimed to provide the patients with the most suitable approach. Based upon the advanced stage of 83 patients, who appeared high risk of distant metastasis for the patients with HPSCC, our center tended to treat the locally advanced patients with IC first, and then decided which approach would be conducted.
IC according to MDT included taxnanes plus platinum with fluorouracil (TPF, n=54), taxanes with platinum (TP, n=15) and fluorouracil with platinum (PF, n=14), all the modalities were administered every 3 weeks.
After IC, CCRT (n=52) or RT alone (n=31) was performed according to the tolerance of patients and MDT discussion. Concurrent chemotherapy was administered every 3 weeks combined with cisplatin or nedaplatin (100 mg/m2 or 80 mg/m2, dependent on the patients’ health condition).
All patients underwent computed tomography (CT)-based RT planning with intensity-modulated radiotherapy (IMRT). Gross tumor volume (GTV) was divided into primary (GTVp) and nodal (GTVnd). Clinical target volume (CTV) included GTVp and additional margins according to the location of the lesion and the presence of adjacent invasions. The CTV of the nodal regions was determined based on the levels of the metastatic lymph nodes. The prescription doses of 95% planning GTV (PGTV) and 95% planning CTV (PTV) were 70 Gy and 60 Gy, respectively, in 33 fractions (once daily, 5 days per week).
Treatment-related toxicities were analyzed according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE, version 4.03).