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).