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treatment of locoregionally advanced head-and-neck cancer;sequential inductionchemo followed by radical chemo-radiation Article Summary

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Sequential induction chemotherapy followed by radical chemo-radiation in the treatment of locoregionally advanced head-and-neck cancer
British Journal of Cancer, 06/20/08
Print     Email This Article     Save in My Library   Free Abstract
Bhide SA et al. – Induction chemotherapy followed by radical chemoradiation is safe and tolerable as treatment of advanced head-and-neck cancer; distant recurrence rates are lower with equivalent local control and survival compared with chemoradiation alone (historical controls)

Methods

  • Retrospective study of 129 advanced head-and-neck cancer pts treated with radical definitive chemoradiation after 2 cycles of induction chemotherapy
  • Induction treatment: cisplatin (75 mg m2) on day 1; 5-FU (1000 mg m2) day 1–4
  • Concomitant treatment: cisplatin (100 mg m- 2) on days 1 and 29
  • Conformal radiation delivery
  • Macroscopic/microscopic disease tissues treated to doses of 65 Gray (Gy) in 30 fractions/50 Gy in 25 fractions, respectively

Results
  • Tumor site: oropharynx, 70 pts (54%); larynx, 30 (23%); hypopharynx, 24 (19%); other 5 (4%)
  • Median follow-up: 19 mp (range: 4–58 mo)
  • At 2 years: local control, 71%; disease-specific survival, 68%; overall survival, 63%; distant recurrence, 9%
  • Induction chemotherapy: dose reduction in 10 pts due to toxicity; 5-FU reduced in 6 pts and cisplatin in 4
  • Grade 3/4 toxicity: neutropenia, 5%; thrombocytopenia, 1%; nausea/vomiting, 3%
  • Concurrent cisplatin: omission of 1 cycle due to toxicity in 23 pt; full-dose radiotherapy for 98% of pts
  • Grade 3/4 toxicity: skin, 20%; dysphagia, 65%; mucositis, 60%; neutropenia, 3%; anaemia, 1%; nausea and vomiting 4%; nephrotoxicity 1%

 

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