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.
Titolo: | Induction chemotherapy followed by simultaneous hyperfractionated radiochemotherapy in advanced head and neck cancer |
Autori: | DE BRAUD, FILIPPO GUGLIELMO MARIA (Secondo) ORECCHIA, ROBERTO (Ultimo) |
Parole Chiave: | Concomitant radiochemotherapy; Head and neck cancer; Hyperfractionated radiotherapy; Induction chemotherapy |
Settore Scientifico Disciplinare: | Settore MED/36 - Diagnostica per Immagini e Radioterapia |
Data di pubblicazione: | 1998 |
Rivista: | |
Tipologia: | Article (author) |
Digital Object Identifier (DOI): | 10.1007/BF03038623 |
Appare nelle tipologie: | 01 - Articolo su periodico |
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