PURPOSE: To evaluate the feasibility of induction chemotherapy followed by concomitant chemotherapy and hyperfractionated irradiation in locally advanced, inoperable head and neck cancer. METHODS: A pilot study was undertaken comprising 3 cycles of cisplatinum (100 mg/m2, day 1) and 5-fluorouracil (1000 mg/m2 in continuous intravenous infusion over the first 120 h) followed by bifractionated radiotherapy applied to tumor/involved lymph nodes up to the dose of 74.4 Gy given in 2 fractions of 1.2 Gy daily for 5 days a week combined with concomitant weekly cisplatinum infusion (50 mg/m2). RESULTS: Six patients were enrolled in the study. All of them completed the protocol therapy. Severe mucositis and myelotoxicity were the most common acute side effects observed in all and in 5 of the patients, respectively. Acute toxicity required interruption of concomitant chemotherapy in 5 cases and in 2 interruption of radiotherapy was necessary. Opioid analgesic parenteral therapy was administered in 4 patients. Three of them had to be hospitalized. One patient experienced cerebral stroke 1 day after the completion of therapy and died 7 days later. Due to high acute toxicity, patient accrual was terminated after 6 patients. At the mean follow-up of 17 months, 4 patients are alive, 3 of them are free of disease and in 1 local progression has been diagnosed. CONCLUSIONS: High acute toxicity of induction cisplatinum and 5-fluorouracil followed by concomitant cisplatinum and hyperfractionated irradiation calls for less toxic treatment schedules in locally advanced inoperable head and neck cancer.
PURPOSE: To evaluate the feasibility of induction chemotherapy followed by concomitant chemotherapy and hyperfractionated irradiation in locally advanced, inoperable head and neck cancer. METHODS: A pilot study was undertaken comprising 3 cycles of cisplatinum (100 mg/m2, day 1) and 5-fluorouracil (1000 mg/m2 in continuous intravenous infusion over the first 120 h) followed by bifractionated radiotherapy applied to tumor/involved lymph nodes up to the dose of 74.4 Gy given in 2 fractions of 1.2 Gy daily for 5 days a week combined with concomitant weekly cisplatinum infusion (50 mg/m2). RESULTS: Six patients were enrolled in the study. All of them completed the protocol therapy. Severe mucositis and myelotoxicity were the most common acute side effects observed in all and in 5 of the patients, respectively. Acute toxicity required interruption of concomitant chemotherapy in 5 cases and in 2 interruption of radiotherapy was necessary. Opioid analgesic parenteral therapy was administered in 4 patients. Three of them had to be hospitalized. One patient experienced cerebral stroke 1 day after the completion of therapy and died 7 days later. Due to high acute toxicity, patient accrual was terminated after 6 patients. At the mean follow-up of 17 months, 4 patients are alive, 3 of them are free of disease and in 1 local progression has been diagnosed. CONCLUSIONS: High acute toxicity of induction cisplatinum and 5-fluorouracil followed by concomitant cisplatinum and hyperfractionated irradiation calls for less toxic treatment schedules in locally advanced inoperable head and neck cancer.
Authors: T G Wendt; G G Grabenbauer; C M Rödel; H J Thiel; H Aydin; R Rohloff; T P Wustrow; H Iro; C Popella; A Schalhorn Journal: J Clin Oncol Date: 1998-04 Impact factor: 44.544
Authors: A A Abitbol; K S Sridhar; A A Lewin; J G Schwade; W Raub; A Wolfson; C Gonzalez-Angulo; A Adessa; W J Goodwin; A M Markoe Journal: Cancer Date: 1997-07-15 Impact factor: 6.860
Authors: A S Glicksman; H J Wanebo; G Slotman; L Liu; C Landmann; J Clark; T C Zhu; A Lohri; R Probst Journal: Int J Radiat Oncol Biol Phys Date: 1997-10-01 Impact factor: 7.038
Authors: N Zamboglou; T Schnabel; C Kolotas; W Achterrath; H Strehl; S Dalhäuser; H G Vogt; L Lenaz; G Schmitt Journal: Semin Oncol Date: 1994-10 Impact factor: 4.929
Authors: G Fountzilas; A Athanassiadis; A Nikolaou; A Kalogera-Fountzila; J Tzitzikas; E Samantas; D Skarlos; N Zamboglou; J Daniilidis Journal: Tumori Date: 1997 Jul-Aug