To assess the influence of hemoglobin (Hb) levels in locally advanced head and neck cancer (LAHNC) patients treated with surgery and postoperative radiotherapy (PORT).Pre- and postoperative Hb levels were collected in 79 patients treated with surgery followed by accelerated PORT for LAHNC. Median follow-up was 52 months (range 12-95 months).Four-year overall survival (OS) rate was 51%. Neither pre- nor postoperative Hb level (< 120 or 130 g/l in women or men, respectively) influenced the outcome. However, when Hb decrease between pre- and postoperative Hb values was taken into account, 4-year OS was significantly higher in patients with Hb difference less than 38 g/l (quartile value) compared with those with Hb decrease 38 g/l or more (61% versus 16%, P = 0.008).Decrease in Hb level by more than 38 g/l after surgery secondary to blood loss influences the outcome when postoperative RT is indicated.

Background The aim of this study was to assess feasibility and efficacy of weekly concomitant boost accelerated postoperative radiation therapy (PORT) with concomitant chemotherapy (CT) in patients with locally advanced head and neck cancer (LAHNC). Methods and Materials Conformal or intensity-modulated 66-Gy RT was performed in 5.5 weeks in 40 patients. Cisplatin was given at days 1, 22, and 43. Median follow-up was 36 months. Results and Discussion Grade 3 mucositis, dysphagia, and erythema was observed in ten (25%), nine (23%), and six (13%) patients, respectively. Grade 3 or more anemia was observed in two (6%) patients, and leukopenia in five (13%) patients. No grade 3 or 4 thrombocytopenia was observed. Grade 3 nephrotoxicity was observed in one patient (3%). No treatment-related mortality was observed. Grade 2 or more xerostomia and edema were observed in ten (25%) and one (3%) patient, respectively. Locoregional relapse occurred in eight patients, and seven patients developed distant metastases. Median time to locoregional relapse was 6 months. Three-year overall, disease-free survival, and locoregional control rates were 63%, 62%, and 81%, respectively. Multivariate analysis revealed that the only prognostic factor was nodal status. Conclusion Reducing overall treatment time using accelerated PORT/CT by weekly concomitant boost (six fractions per week) combined with concomitant cisplatin CT is easily feasible with acceptable morbidity.

Postoperative radiation therapy (PORT) in non small cell lung cancer (NSCLC) remains controversial. However, involved-field conformal (3D) RT has never been studied prospectively. In this study, we aim to assess the outcome of patients treated with involved-field 3D PORT with or without chemotherapy in NSCLC. From September 1996 to 2006, data from 75 patients treated with curative surgery and PORT for NSCLC were retrospectively analyzed. Median age was 58 years (range: 38-76). There were 5 patients with stage I, 22 with stage II, and 48 with stage III disease. Pneumonectomy or lobectomy was realized in 24 (32%) and 51 (68%) patients, respectively. Mediastinal lymphadenectomy was performed in all patients. Chemo-therapy was given in 15 (20%). All patients had 3D conformal planning. Median RT dose was 60 Gy, and CTV included bronchial stump and only positive nodal areas. All patients have completed full treatment. With a median follow-up of 55 months, 26 patients are alive without disease. Median overall survival time was 24 months, with survival rate of 35% at 5 years. The 5-year locoregional control and distant disease-free rates were 80% and 57%, respectively (Fig.1). Patients treated with pneumonectomy and those treated with at least 60-Gy PORT had better outcome (Fig.2). Grade 3 or more CTC v3.0 toxicity was observed only in 4 (5%) pts. We conclude that involved-field 3D conformal 60-Gy PORT improves locoregional control without increasing lethal toxicity.