Document Detail


Low-dose weekly platinum-based chemoradiation for advanced head and neck cancer.
MedLine Citation:
PMID:  19950378     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES/HYPOTHESIS: The optimal concurrent chemoradiotherapy regimen for definitive treatment of locoregionally advanced head and neck cancer remains to be determined. The present investigation reports toxicities, disease control, patterns of failure, and survival outcomes in a large mature cohort of patients treated with low-dose weekly platinum-based concurrent chemoradiotherapy. STUDY DESIGN: Retrospective single-institution series. METHODS: Toxicity and outcome data for locoregionally advanced head and neck cancer patients treated with low-dose weekly platinum-based chemotherapy concurrent with standard fractionation radiotherapy were retrospectively collected and analyzed from a clinical database. Survival analysis methods, including Kaplan-Meier estimation and competing risks analysis, were used to assess locoregional disease control, freedom from failure, and overall survival. RESULTS: Ninety-six patients were eligible for the present analysis. Nearly all patients had American Joint Committee on Cancer clinical stage III to IVB disease (99%). Severe acute toxicities included grade 3 mucositis (61%), grade 3/4 nausea (27%/1%), and grade 3 neutropenia (8%). Thirty-seven patients (38%) required hospitalization for a median of 7 days (range, 1-121). Ninety-two percent of patients completed the fully prescribed course of radiotherapy, and 87% completed >or=6 cycles of chemotherapy. At a median survivor follow-up of 40 months (range, 8-68), 47% of patients were without evidence of disease recurrence. The estimated 4-year freedom from failure and overall survival were 48% and 58%, respectively. Initial site(s) of disease failure were locoregional for 22 patients, locoregional and distant (five patients), and distant only (14 patients). CONCLUSIONS: Weekly low-dose platinum-based chemotherapy with full-dose daily radiotherapy is a tolerable alternative regimen for locoregionally advanced head and neck cancers, with comparable efficacy and patterns of failure to alternative regimens.
Authors:
John M Watkins; A Jason Zauls; Amy H Wahlquist; Keisuke Shirai; Elizabeth Garrett-Mayer; M Boyd Gillespie; Terry A Day; Anand K Sharma
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Laryngoscope     Volume:  120     ISSN:  1531-4995     ISO Abbreviation:  Laryngoscope     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-01-26     Completed Date:  2010-02-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  236-42     Citation Subset:  IM    
Affiliation:
Department of Radiation Oncology, Medical University of South Carolina, Charleston, South Carolina 29414, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Antineoplastic Combined Chemotherapy Protocols / administration & dosage*,  adverse effects
Cisplatin / administration & dosage
Combined Modality Therapy
Drug Administration Schedule
Female
Head and Neck Neoplasms / drug therapy*,  pathology,  radiotherapy
Humans
Male
Middle Aged
Paclitaxel / administration & dosage
Radiation Injuries
Survival Rate
Chemical
Reg. No./Substance:
15663-27-1/Cisplatin; 33069-62-4/Paclitaxel

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