PURPOSE: Despite aggressive surgery and postoperative radiation therapy, only 30% of patients who have advanced, potentially resectable carcinomas of the head and neck survive for 5 years. In the hope of improving this situation we studied the effect of postoperative radiotherapy delivered concurrently with cisplatin. METHODS AND MATERIALS: Patients who had Stage IV tumors and/or involved surgical margins received 60 Gy in 30 fractions over 6 weeks plus 100 mg/m2 of cisplatin on radiotherapy days 1, 23 and 43. Fifty-two patients participated in this trial and 51 were evaluated. Forty-three (84%) patients had pathologic T3 or T4 disease, 43 (84%) had Stage IV disease, and 27 (53%) had histologically involved surgical margins. RESULTS: Severe and life-threatening toxicities occurred in 20% and 12% of patients, respectively; the most common drug-related toxicities were leukopenia, anemia, nausea, and vomiting. Seventeen patients (43%) remain alive with no evidence of disease. Four patients (8%) died with no evidence of neoplastic disease, and one patient has died of a second independent malignancy. By actuarial analysis at 3 years, 48% of patients are alive, 81% have locoregional control of disease, and 57% are free of distant metastases. CONCLUSIONS: Based on comparison with similar patients treated in a prior Radiation Therapy Oncology Group/Intergroup trial (RTOG), we conclude that postoperative radiotherapy with concurrent cisplatin may improve locoregional control rates and should be prospectively tested.
PURPOSE: Despite aggressive surgery and postoperative radiation therapy, only 30% of patients who have advanced, potentially resectable carcinomas of the head and neck survive for 5 years. In the hope of improving this situation we studied the effect of postoperative radiotherapy delivered concurrently with cisplatin. METHODS AND MATERIALS: Patients who had Stage IV tumors and/or involved surgical margins received 60 Gy in 30 fractions over 6 weeks plus 100 mg/m2 of cisplatin on radiotherapy days 1, 23 and 43. Fifty-two patients participated in this trial and 51 were evaluated. Forty-three (84%) patients had pathologic T3 or T4 disease, 43 (84%) had Stage IV disease, and 27 (53%) had histologically involved surgical margins. RESULTS: Severe and life-threatening toxicities occurred in 20% and 12% of patients, respectively; the most common drug-related toxicities were leukopenia, anemia, nausea, and vomiting. Seventeen patients (43%) remain alive with no evidence of disease. Four patients (8%) died with no evidence of neoplastic disease, and one patient has died of a second independent malignancy. By actuarial analysis at 3 years, 48% of patients are alive, 81% have locoregional control of disease, and 57% are free of distant metastases. CONCLUSIONS: Based on comparison with similar patients treated in a prior Radiation Therapy Oncology Group/Intergroup trial (RTOG), we conclude that postoperative radiotherapy with concurrent cisplatin may improve locoregional control rates and should be prospectively tested.
Authors: Carter Van Waes; Clint T Allen; Deborah Citrin; David Gius; A Dimetrios Colevas; Nancy A Harold; Susan Rudy; Liesl Nottingham; Christine Muir; Zhong Chen; Anurag K Singh; Janet Dancey; John C Morris Journal: Int J Radiat Oncol Biol Phys Date: 2009-10-30 Impact factor: 7.038
Authors: Khaled Al-Qahtani; Jen Rieger; Jeffery R Harris; Alex Mlynarek; David Williams; Tahera Islam; Hadi Seikaly Journal: Eur Arch Otorhinolaryngol Date: 2014-06-25 Impact factor: 2.503
Authors: Petr Szturz; Kristien Wouters; Naomi Kiyota; Makoto Tahara; Kumar Prabhash; Vanita Noronha; Ana Castro; Lisa Licitra; David Adelstein; Jan B Vermorken Journal: Oncologist Date: 2017-05-22
Authors: C Matuschek; E Bölke; C Belka; U Ganswindt; M Henke; P Stegmaier; M Bamberg; S Welz; J Debus; A Gioules; A Voigt; G Volk; C Ohmann; T Wiegel; V Budach; M Stuschke; J Schipper; P A Gerber; W Budach Journal: Strahlenther Onkol Date: 2013-07-05 Impact factor: 3.621
Authors: Aline Lima da Silva Deboni; Adelmo José Giordani; Nilza Nelly Fontana Lopes; Rodrigo Souza Dias; Roberto Araujo Segreto; Siri Beier Jensen; Helena Regina Comodo Segreto Journal: Support Care Cancer Date: 2012-03-13 Impact factor: 3.603
Authors: Z Kassam; H Mackay; C A Buckley; S Fung; M Pintile; A Oza; J Brierley; C Swallow; B Cummings; J J Knox; J Kim; R Wong; L Siu; R Feld; J Ringash Journal: Curr Oncol Date: 2010-08 Impact factor: 3.677