Intensive concomitant chemoradiotherapy in locally advanced unresectable squamous cell carcinoma of the head and neck: a phase II study of radiotherapy with cisplatin and 7-week continuous infusional fluorouracil
| Autor: | E. Tellez Bernal, T. Guillot, Cecil O. Borel, Bernard Luboinski, Gonzalo Recondo, Esteban Cvitkovic, Christian Domenge, François Janot, François Eschwege, M. de Forni, J.P. Armand, Mohamed-El-Amine Bensmaïne, Pierre Wibault |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Antimetabolites Antineoplastic medicine.medical_treatment Phases of clinical research Risk Factors Antineoplastic Combined Chemotherapy Protocols medicine Carcinoma Mucositis Humans Infusions Intravenous Aged Neoplasm Staging Chemotherapy business.industry Cancer Middle Aged medicine.disease Prognosis Survival Analysis Surgery Radiation therapy Treatment Outcome Oncology Epidermoid carcinoma Fluorouracil Chemotherapy Adjuvant Head and Neck Neoplasms Carcinoma Squamous Cell Feasibility Studies Patient Compliance Female Radiotherapy Adjuvant Cisplatin business medicine.drug |
| Zdroj: | Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 14(4) |
| ISSN: | 0732-183X |
| Popis: | PURPOSE To evaluate an intensive concomitant chemoradiotherapy protocol of conventional radiotherapy with intermittent cisplatin (CDDP) and continuous-infusion fluorouracil (5-FU) in unresectable, locally advanced squamous cell carcinoma of the head and neck (SCCHN). PATIENTS AND METHODS Fifty-seven patients with unresectable stage IV MO disease (International Union Against Cancer [UICC]/American Joint Committee on Cancer [AJCC], 1987) received radiotherapy 70 Gy followed by CDDP 80 mg/m2 and 5-FU 300 mg/m2/d. Response was assessed 2 months after treatment completion. RESULTS Thirty patients (52%) received the full treatment schedule; 53 (93%) received full-dose radiotherapy, while 48 (84%) were given at least 75% of the planned chemotherapy doses. Severe mucositis (World Health Organization [WHO]) grade 3 to 4 was the limiting toxicity and was seen in 79% of patients. The median time for mucositis resolution was 8 weeks. Other toxicities were generally manageable, but there were four treatment related deaths (7%). Fifty patients were assessable for activity, with an overall response rate of 70% (95% confidence interval [CI], 58% to 82%). Complete response (CR) and partial response (PR) rates were 42% and 28%, respectively. CONCLUSION This simultaneous combined-modality regimen was feasible at the cost of severe mucosal toxicity, which required hospitalization with nutritional, parenteral, and hydroelectrolytic support. The high response rate achieved (70%) did not translate into improved survival, probably due to patient eligibility. The likelihood of cure of this high-tumoral-volume patient population remains low (approximately 10%), despite the association of two therapeutic modalities at full standard therapeutic intensity. |
| Databáze: | OpenAIRE |
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