Long-term survival after definitive radiotherapy combined with systemic therapy in locally-advanced head and neck squamous cell carcinoma in a single practice in Medellín, Colombia Supervivencia a largo plazo posterior a la radioterapia definitiva combinada con terapia sistémica en carcinoma de células escamosas de cabeza y cuello localmente avanzado en una sola práctica médica en Medellín, Colombia.

Abstract

Objetive: Describe survival outcomes in a cohort of patients with Locally-Advanced Head and Neck Squamous Cell Carcinoma (LA-HNSCC) treated in Colombia. Materials and methods:  We carried out an observational study. We retrospectively reviewed clinical characteristics and outcomes of all adult patients treated between 2001 and 2018 at a single medical practice in Colombia with LA-HNSCC.  Overall survival (OS) and disease-free survival (DFS) were evaluated using Kaplan- Meier curves. Data processing was performed using SPSS v.22. Results: 60 patients were included, 70% were males. The 30% of carcinomas were oropharyngeal. Stage IVA accounted for 29 (48.3%) patients. Surgery with curative intent was performed in 17 (28.3%). Concomitant cisplatin-based chemoradiotherapy or bioradiotherapy with cetuximab were delivered to 29 (48.3%) and 12 (20%), respectively. The remainder, 19 (31.7%) patients, were treated with radiation therapy and chemotherapy in various sequential or alternating approaches. There were no treatment-related deaths in this cohort. In 41 patients treated with radiotherapy concurrently with either cisplatin or cetuximab the 50-month survival was 75.5%, and no further progression or deaths were recorded on further follow-up. Median follow-up was 35.2 months (14.8-73.8). Median OS and DFS were both estimated at 118.9 months. Conclusion: The integration of systemic therapy to definitive radiation therapy is feasible in a Real-World scenario for locally- advanced HNSCC in Colombia.