Enhanced acute toxicity in oropharynx carcinoma treated with radiotherapy and concomitant cisplatin, 5-fluorouracil and mitomycin C
| Autor: | Garand G, A. Reynaud-Bougnoux, O. Le Floch, Gilles Calais, Sophie Chapet, C. Berger |
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| Rok vydání: | 1996 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Mitomycin medicine.medical_treatment Pilot Projects Neutropenia Gastroenterology Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Mucositis Humans Prospective Studies Survival rate Aged Chemotherapy Radiotherapy business.industry Middle Aged medicine.disease Combined Modality Therapy Surgery Survival Rate Oropharyngeal Neoplasms Oncology Epidermoid carcinoma Fluorouracil Concomitant Carcinoma Squamous Cell Patient Compliance Cisplatin business Febrile neutropenia Follow-Up Studies medicine.drug |
| Zdroj: | European Journal of Cancer. 32:1707-1711 |
| ISSN: | 0959-8049 |
| DOI: | 10.1016/0959-8049(96)00173-6 |
| Popis: | The aim of this study was to establish the feasibility of giving concomitant radiotherapy and 3 cycles of chemotherapy with cisplatin (CDDP), 5-fluorouracil (5-FU) and mitomycin C (MMC) in locally advanced inoperable oropharyngeal cancer. From March 1990 to September 1993, 27 male patients (mean age 55 years) were included in this study. 3 patients (11%) were T2N0, 19 (70%) T3 (T3N0: n = 9, T3N1: n = 1, T3N2: n = 5, T3N3: n = 4), and 5 (19%) T4 (T4N0: n = 1, T4N1: n = 1, T4N2: n = 2, T4N3: n = 1). All patients received conventional radiotherapy delivering 70 Gy in 35 fractions and 52 days, and three cycles of chemotherapy starting on day 1, 21 and 42 with CDDP 20 mg/m2 and 5-FU 400 mg/m2 day 1 to day 4, and MMC 10 mg/m2 day 1. With a mean follow-up of 34 months (17-59), 10 patients (37%) were alive and free of disease. Among the 17 other patients, 8 died of cancer. Crude locoregional control rate was 78%, and probability of local control at 1 and 2 years was 85 and 80%, respectively. One- and 2-year survival rates were 48 and 31%, respectively, for both overall and disease-free survival. Grade 3 or 4 mucositis occurred in 22 patients (81%); enteral feeding was necessary for 63%; mean weight loss was 5.7 kg. Grade > 2 thrombocytopenia occurred in 11 patients (41%), grade > 2 neutropenia in 8 patients (29%), grade > 2 anaemia in 4 patients (15%). Febrile neutropenia or aplasia occurred in 5 patients (19%). 2 patients (7%) died during treatment of haematological or infectious complications related to the treatment. Another patient died 1 month after treatment with grade 4 thrombocytopenia and septicaemia. In conclusion, a high complete response rate has been achieved with this concomitant chemo- and radiotherapy, but with severe digestive and haematological toxicity. Addition of MMC to 5-FU and CDDP might have been responsible for this increased toxicity. This therapeutic combination is therefore not routinely feasible. |
| Databáze: | OpenAIRE |
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