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Induction chemotherapy and concurrent chemoradiotherapy for locoregionally advanced head and neck cancer: a multi-institutional phase II trial investigating three radiotherapy dose levels

Salama, J.K. ; Stenson, K.M. ; Kistner, E.O. ; Mittal, B.B. ; Argiris, A. ; Witt, M.E. ; Rosen, F. ; Brockstein, B.E. ; Cohen, E.E.W. ; Haraf, D.J. ; Vokes, E.E.

Annals of oncology, 2008-10, Vol.19 (10), p.1787-1794 [Periódico revisado por pares]

Oxford: Elsevier Ltd

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Título:
Induction chemotherapy and concurrent chemoradiotherapy for locoregionally advanced head and neck cancer: a multi-institutional phase II trial investigating three radiotherapy dose levels
Autor: Salama, J.K. ; Stenson, K.M. ; Kistner, E.O. ; Mittal, B.B. ; Argiris, A. ; Witt, M.E. ; Rosen, F. ; Brockstein, B.E. ; Cohen, E.E.W. ; Haraf, D.J. ; Vokes, E.E.
Assuntos: Adult ; Aged ; Antineoplastic agents ; Antineoplastic Combined Chemotherapy Protocols - adverse effects ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Carboplatin - administration & dosage ; Carboplatin - adverse effects ; Carcinoma, Squamous Cell - drug therapy ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - radiotherapy ; chemoradiotherapy ; Cohort Studies ; Combined Modality Therapy ; Disease-Free Survival ; Dose-Response Relationship, Radiation ; Female ; Fluorouracil - administration & dosage ; Fluorouracil - adverse effects ; Head and Neck Neoplasms - drug therapy ; Head and Neck Neoplasms - pathology ; Head and Neck Neoplasms - radiotherapy ; Humans ; Hydroxyurea - administration & dosage ; Hydroxyurea - adverse effects ; induction chemotherapy ; locoregionally advanced head and neck cancer ; Male ; Medical sciences ; Middle Aged ; Neoplasm Staging ; Otorhinolaryngology (head neck, general aspects and miscellaneous) ; Otorhinolaryngology. Stomatology ; Paclitaxel - administration & dosage ; Paclitaxel - adverse effects ; Pharmacology. Drug treatments ; Remission Induction ; Tumors
É parte de: Annals of oncology, 2008-10, Vol.19 (10), p.1787-1794
Notas: ark:/67375/HXZ-R8SJMKPD-T
istex:363B036981B5FA5BDA7E1BFC7CEEF643CA346F0C
Descrição: We hypothesized induction chemotherapy (IndCT) would improve distant control (DC) without compromising locoregional control (LRC) for locoregionally advanced head and neck cancer patients. Additionally, we systematically lowered radiotherapy (RT) doses attempting to maintain LRC while decreasing toxicity. Stages III–IV (M0) locoregionally advanced head and neck cancer patients received carboplatin/paclitaxel (Taxol) IndCT followed by four or five cycles consisting of 5 days of paclitaxel, fluorouracil, hydroxyurea, and BID RT followed by a nine day break. RT dose to gross disease (high risk), intermediate, and low-risk volumes were reduced from cohort A (n = 68): 75, 60, and 45 Gy; to cohort B (n = 64): 75, 54, and 39 Gy; then cohort C (n = 90): 72, 51, and 36 Gy. A total of 222 patients accrued from November 1998 to September 2002. Median follow-up is 56 months. In all, 93/96/76% achieved a complete response to concurrent chemoradiotherapy (CRT) in cohort A/B/C. Three- and 5-year overall survivals (OSs) are 68% and 62%, respectively. Five-year LRC and DC are 91% and 87%, respectively. Response to IndCT predicted for OS, LRC, and time to progression (TTP). Cohort C patients had similar OS (P = 0.95), LRC, and DC, but worse (TTP) (P = 0.027). IndCT before CRT reduces distant progression while maintaining high LRC. The cohort B schedule provides the best therapeutic ratio. A randomized trial investigating IndCT before CRT has been initiated.
Editor: Oxford: Elsevier Ltd
Idioma: Inglês

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Induction chemotherapy and concurrent chemoradiotherapy for locoregionally advanced head and neck cancer: a multi-institutional phase II trial investigating three radiotherapy dose levels

Salama, J.K. ; Stenson, K.M. ; Kistner, E.O. ; Mittal, B.B. ; Argiris, A. ; Witt, M.E. ; Rosen, F. ; Brockstein, B.E. ; Cohen, E.E.W. ; Haraf, D.J. ; Vokes, E.E.

Oxford: Elsevier Ltd

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