PURPOSE: Reirradiation (re-RT) with concurrent chemotherapy offers a therapeutic option in patients who have locoregional recurrence of head and neck cancer (HNC). The hypoxic cell sensitizer, tirapazamine (TPZ), has demonstrated promising results in first-line therapy for HNC. This phase I trial was designed to test the feasibility of giving TPZ in the re-RT setting. METHODS AND MATERIALS: Patients with recurrent HNC who received prior radiotherapy (RT) were enrolled and received TPZ (260 mg/m2) and cisplatin (50 mg/m2) Weeks 1, 3, and 5 concurrently with RT (72 Gy, 42 fractions over 6 weeks). TPZ (160 mg/m2) alone was added on Days 1, 3, and 5 of Week 2 (cohort 1) or Weeks 2 and 4 (cohort 2). RESULTS: Twenty-five subjects were enrolled, 7 and 18 on cohorts 1 and 2, respectively. Significant toxicities included Grade 3 dermatitis (20%) and Grade 3 mucositis (40%). Dose-limiting toxicity was observed on cohort 2 (1 patient with aspiration pneumonia). Four deaths occurred during treatment. Two fatalities occurred after completing therapy as a result of carotid artery rupture. With a minimum and median follow-up of 14 and 24 months, respectively, median overall survival was 14 months with actuarial 1-year and 2-year survival of 56% and 27%, respectively. CONCLUSION: Reirradiation with concomitant chemotherapy including TPZ in patients with unresectable recurrent HNC is feasible and results in long-term survival in a significant proportion of patients.
PURPOSE: Reirradiation (re-RT) with concurrent chemotherapy offers a therapeutic option in patients who have locoregional recurrence of head and neck cancer (HNC). The hypoxic cell sensitizer, tirapazamine (TPZ), has demonstrated promising results in first-line therapy for HNC. This phase I trial was designed to test the feasibility of giving TPZ in the re-RT setting. METHODS AND MATERIALS: Patients with recurrent HNC who received prior radiotherapy (RT) were enrolled and received TPZ (260 mg/m2) and cisplatin (50 mg/m2) Weeks 1, 3, and 5 concurrently with RT (72 Gy, 42 fractions over 6 weeks). TPZ (160 mg/m2) alone was added on Days 1, 3, and 5 of Week 2 (cohort 1) or Weeks 2 and 4 (cohort 2). RESULTS: Twenty-five subjects were enrolled, 7 and 18 on cohorts 1 and 2, respectively. Significant toxicities included Grade 3 dermatitis (20%) and Grade 3 mucositis (40%). Dose-limiting toxicity was observed on cohort 2 (1 patient with aspiration pneumonia). Four deaths occurred during treatment. Two fatalities occurred after completing therapy as a result of carotid artery rupture. With a minimum and median follow-up of 14 and 24 months, respectively, median overall survival was 14 months with actuarial 1-year and 2-year survival of 56% and 27%, respectively. CONCLUSION: Reirradiation with concomitant chemotherapy including TPZ in patients with unresectable recurrent HNC is feasible and results in long-term survival in a significant proportion of patients.
Authors: David I Rosenthal; Clifton D Fuller; Jerry L Barker; Bryan Mason; John A Garcia; Jan S Lewin; F Christopher Holsinger; C Richard Stasney; Steven J Frank; David L Schwartz; William H Morrison; Adam S Garden; K Kian Ang Journal: Int J Radiat Oncol Biol Phys Date: 2009-08-11 Impact factor: 7.038
Authors: M G Fury; E J Sherman; S S Rao; S Wolden; S Smith-Marrone; B Mueller; K K Ng; P R Dutta; D Y Gelblum; J L Lee; R Shen; S Kurz; N Katabi; S Haque; N Y Lee; D G Pfister Journal: Ann Oncol Date: 2014-02-03 Impact factor: 32.976
Authors: Kelly K Curtis; Helen J Ross; Ashley L Garrett; Theresa A Jizba; Ajay B Patel; Samir H Patel; William W Wong; Michele Y Halyard; Stephen J Ko; Heidi E Kosiorek; Robert L Foote Journal: Radiat Oncol Date: 2016-04-09 Impact factor: 3.481
Authors: Carlos Miguel Chiesa Estomba; Frank Alberto Betances Reinoso; Alejandra Osorio Velasquez; Olalla Castro Macia; Maria Jesus Gonzalez Cortés; Jesus Araujo Nores Journal: Braz J Otorhinolaryngol Date: 2016-09-29