RT Journal Article SR Electronic T1 Induction Chemotherapy and Sequential Concomitant Chemo-radiation in Locally Advanced Head and Neck Cancers: How Induction-phase Intensity and Treatment Breaks May Impact on Clinical Outcomes JF Anticancer Research JO Anticancer Res FD International Institute of Anticancer Research SP 6247 OP 6254 VO 35 IS 11 A1 PIERFRANCESCO FRANCO A1 ILENIA POTENZA A1 MARINA SCHENA A1 GIUSEPPE RIVA A1 GIANCARLO PECORARI A1 PAOLO GARZINO DEMO A1 MASSIMO FASOLIS A1 FRANCESCO MORETTO A1 MASSIMILIANO GARZARO A1 JACOPO DI MUZIO A1 MARCO MELANO A1 MARIO AIROLDI A1 RICCARDO RAGONA A1 MONICA RAMPINO A1 UMBERTO RICARDI YR 2015 UL http://ar.iiarjournals.org/content/35/11/6247.abstract AB Aim: The purpose of the study was to assess outcomes of locally advanced head and neck (LAHNC) treated with induction chemotherapy (ICT) and subsequent concurrent chemo-radiation. Patients and Methods: A total of 71 LAHNC patients were treated with 2-3 cycles of docetaxel, cisplatin and 5-fluorouracil as induction chemotherapy and subsequent concurrent chemoradiation with weekly cisplatin or carboplatin. Definitive radiotherapy was delivered with intensity-modulated radiation and a simultaneous integrated boost approach up to a total dose of 70 Gy in 35 fractions to the macroscopic primary and nodal disease. Results: Actuarial 2-year OS, CSS, DFS, MFS, LC were 55.3% (95%CI=39.3-68.6), 58.6% (95%CI=41.9-72), 60.5% (95%CI=47.3-71.4), 87.3% (95%CI=76.2-93.5) and 74.7% (95%CI=61.5-83.9), respectively. On multivariate analysis undergoing to 3 vs. 2 cycles of TPF (HR=22.31; 95%CI=2.68-185.66; p=0.004) and radiotherapy treatment break >4 days (HR=1.28; 95%CI=1.06-1.55; p=0.01) negatively affected cancer-specific survival (CSS) with statistical significance. Achieving complete remission after ICT had a statistically significant impact on CSS (HR=0.9; 95%CI=0.01-0.54; p=0.009). Patients undergoing ICT with 3 cycles had more frequently treatment breaks compared to those submitted to 2 cycles (HR=1.36; 95%CI=1.06-1.73; p=0.01), and had statistically significant longer treatment break time (5.9+1.8 vs. 3+0.36; p=0.02). Conclusion: A shorter ICT phase may be a better option enhancing patients' tolerance during concurrent chemoradiation and affecting clinical outcomes.