{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T22:26:07Z","timestamp":1762899967022,"version":"3.37.3"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T00:00:00Z","timestamp":1594771200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T00:00:00Z","timestamp":1594771200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Transl Oncol"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Purpose<\/jats:title>\n                <jats:p>Radiochemotherapy (RCT) is an effective standard therapy for locally advanced head and neck squamous cell carcinoma (LA-HNSCC). Nonetheless, toxicity is common, with patients often requiring dose modifications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>To investigate associations of RCT toxicities according to CTCAE version 5.0 and subsequent therapy modifications with short- and long-term treatment outcomes, we studied all 193 patients with HNSCC who received RCT (70\u00a0Gy\u2009+\u2009platinum agent) at an academic center between 03\/2010 and 04\/2018.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>During RCT, 77 (41%, 95% CI 34\u201349) patients developed at least one\u2009\u2265\u2009grade 3 toxicity, including seven grade 4 and 3 fatal grade 5 toxicities. The most frequent any-grade toxicities were xerostomia (<jats:italic>n<\/jats:italic>\u2009=\u2009187), stomatitis (<jats:italic>n<\/jats:italic>\u2009=\u2009181), dermatitis (<jats:italic>n<\/jats:italic>\u2009=\u2009174), and leucopenia (<jats:italic>n<\/jats:italic>\u2009=\u200998). Eleven patients (6%) had their radiotherapy schedule modified (mean radiotherapy dose reduction\u2009=\u200912\u00a0Gy), and 120 patients (64%) had chemotherapy modifications (permanent discontinuation: <jats:italic>n<\/jats:italic>\u2009=\u200967, pause: <jats:italic>n<\/jats:italic>\u2009=\u200934, dose reduction: <jats:italic>n<\/jats:italic>\u2009=\u20097, change to other chemotherapy: <jats:italic>n<\/jats:italic>\u2009=\u200910). Objective response rates to RCT were 55% and 88% in patients with and without radiotherapy modifications (<jats:italic>p<\/jats:italic>\u2009=\u20090.003), and 84% and 88% in patients with and without chemotherapy modifications (<jats:italic>p<\/jats:italic>\u2009=\u20090.468), respectively. Five-year progression-free survival estimates were 20% and 50% in patients with and without radiotherapy modifications (<jats:italic>p<\/jats:italic>\u2009=\u2009&lt;\u20090.001), and 53% and 40% in patients with and without chemotherapy modifications (<jats:italic>p<\/jats:italic>\u2009=\u20090.88), respectively.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Reductions of radiotherapy dose were associated with impaired long-term outcomes, whereas reductions in chemotherapy intensity were not. This suggests that toxicities during RCT should be primarily managed by modifying chemotherapy rather than radiotherapy.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s12094-020-02447-y","type":"journal-article","created":{"date-parts":[[2020,7,15]],"date-time":"2020-07-15T06:15:35Z","timestamp":1594793735000},"page":"543-553","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Decrease in treatment intensity predicts worse outcome in patients with locally advanced head and neck squamous cell carcinoma undergoing radiochemotherapy"],"prefix":"10.1007","volume":"23","author":[{"given":"S.","family":"Mollnar","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.","family":"Pondorfer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.-K.","family":"Kasparek","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Reinisch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Moik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Stotz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Halm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Szkandera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Terbuch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.","family":"Eisner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Gerger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. 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