BACKGROUND: Since 1989, 105 patients with squamous head and neck cancer have been treated with combined chemoradiotherapy. OBJECTIVE: To examine the effectiveness of using combined chemoradiotherapy on patients with squamous head and neck cancer. DESIGN: Eight-year (1989-1997) single-institution evaluation of 105 patients. METHODS: Treatment consisted of fluorouracil, 1000 mg/m2 per day, and cisplatin, 20 mg/m2 per day, both given as continuous infusions during 4 days beginning on day 1 and 22 of a concurrent radiotherapy course. Radiation was given in single daily fractions of 1.8 to 2 Gy, to a total dose of 66 to 72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Planned neck dissection was recommended for all patients with N2+ neck disease, irrespective of clinical response. RESULTS: The 105-patient cohort consisted of 79 men and 26 women. The primary site was identified in the oral cavity in 6, oropharynx in 46, larynx in 30, and hypopharynx in 20 patients. Two patients had multiple primaries and 1 patient had an unknown primary. There were 4 patients with stage II, 24 with stage III, and 77 with stage IV disease. Grade 3 and 4 chemoradiotherapy toxic effects included mucositis in 88% of patients, cutaneous reaction in 50%, neutropenia in 49%, thrombocytopenia in 12%, and nausea in 5%. There were no deaths secondary to treatment. The mean weight loss was 12% of initial body weight. To date, primary site persistence or recurrence has occurred in only 14 patients (13%). With a mean follow-up of 39 months, 66 patients (63%) are alive and free of disease. The Kaplan-Meier 4-year projected overall survival is 60% with a disease-specific survival of 74%, a distant metastasis-free survival of 84%, and an overall survival with primary site preserved of 54%. CONCLUSIONS: This chemoradiotherapy regimen, although toxic, is tolerable with appropriate supportive intervention. Locoregional and distant control are likely. Primary site conservation is possible in most patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancer.
BACKGROUND: Since 1989, 105 patients with squamous head and neck cancer have been treated with combined chemoradiotherapy. OBJECTIVE: To examine the effectiveness of using combined chemoradiotherapy on patients with squamous head and neck cancer. DESIGN: Eight-year (1989-1997) single-institution evaluation of 105 patients. METHODS: Treatment consisted of fluorouracil, 1000 mg/m2 per day, and cisplatin, 20 mg/m2 per day, both given as continuous infusions during 4 days beginning on day 1 and 22 of a concurrent radiotherapy course. Radiation was given in single daily fractions of 1.8 to 2 Gy, to a total dose of 66 to 72 Gy. Salvage surgery was performed for any residual or recurrent locoregional disease. Planned neck dissection was recommended for all patients with N2+ neck disease, irrespective of clinical response. RESULTS: The 105-patient cohort consisted of 79 men and 26 women. The primary site was identified in the oral cavity in 6, oropharynx in 46, larynx in 30, and hypopharynx in 20 patients. Two patients had multiple primaries and 1 patient had an unknown primary. There were 4 patients with stage II, 24 with stage III, and 77 with stage IV disease. Grade 3 and 4 chemoradiotherapy toxic effects included mucositis in 88% of patients, cutaneous reaction in 50%, neutropenia in 49%, thrombocytopenia in 12%, and nausea in 5%. There were no deaths secondary to treatment. The mean weight loss was 12% of initial body weight. To date, primary site persistence or recurrence has occurred in only 14 patients (13%). With a mean follow-up of 39 months, 66 patients (63%) are alive and free of disease. The Kaplan-Meier 4-year projected overall survival is 60% with a disease-specific survival of 74%, a distant metastasis-free survival of 84%, and an overall survival with primary site preserved of 54%. CONCLUSIONS: This chemoradiotherapy regimen, although toxic, is tolerable with appropriate supportive intervention. Locoregional and distant control are likely. Primary site conservation is possible in most patients. Chemoradiotherapy appears to have an emerging role in the primary management of head and neck cancer.
Authors: Oliver Driemel; Tobias Ettl; Oliver Kölbl; Torsten E Reichert; Bernd V Dresp; Jürgen Reuther; Hans Pistner Journal: Strahlenther Onkol Date: 2009-05-15 Impact factor: 3.621
Authors: Agostino Paccagnella; Michela Morello; Maria C Da Mosto; Carla Baruffi; Maria L Marcon; Alessandro Gava; Vittorio Baggio; Stefano Lamon; Roberta Babare; Giovanni Rosti; Marta Giometto; Paolo Boscolo-Rizzo; Edward Kiwanuka; Michele Tessarin; Lorenza Caregaro; Carlo Marchiori Journal: Support Care Cancer Date: 2009-08-30 Impact factor: 3.603
Authors: Thomas Kuhnt; Axel Becker; Marc Bloching; Johannes Schubert; Gunther Klautke; Rainer Fietkau; Juergen Dunst Journal: Med Oncol Date: 2006 Impact factor: 3.738
Authors: David Zaboli; Marietta Tan; Hrishikesh Gogineni; Spencer Lake; Katherine Fan; Marianna L Zahurak; Barbara Messing; Karen Ulmer; Eva S Zinreich; Marshall A Levine; Mei Tang; Sara I Pai; Ray G Blanco; John R Saunders; Simon R Best; Joseph A Califano; Patrick K Ha Journal: Int J Otolaryngol Date: 2012-06-21
Authors: Giulia Bertino; Antonio Occhini; Carlo Emilio Falco; Camillo Porta; Franco Corbella; Sara Colombo; Vittoria Balcet; Patrizia Morbini; Federico Zappoli; Andrea Azzaretti; Giuseppe Rodolico; Carmine Tinelli; Marco Benazzo Journal: BMC Cancer Date: 2009-09-04 Impact factor: 4.430