Use of high-dose cytarabine to enhance cisplatin cytotoxicity—effects on the response and overall survival rates of advanced head and neck cancer patients

2002 ◽  
Vol 38 (11) ◽  
pp. 1478-1489 ◽  
Author(s):  
S Jelić ◽  
Lj Stamatović ◽  
S Vučićević ◽  
Ž Petrović ◽  
M Kreačić ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Survival Rates ◽  
High Dose ◽  
Advanced Head ◽  
High Dose Cytarabine ◽  
Cytotoxicity Effects ◽  
Overall Survival Rates

Compliance and Outcomes in Locally Advanced Head and Neck Cancer Patients Treated with Alternating Chemoradiotherapy in Clinical Practice

2003 ◽  
Vol 89 (1) ◽  
pp. 20-25 ◽  
Author(s):  
Vittorio Franciosi ◽  
Marco Fumagalli ◽  
Luciana Biscari ◽  
Roberto Martinelli ◽  
Teore Ferri ◽  
...  
Keyword(s):  
Overall Survival ◽  
Head And Neck Cancer ◽  
Clinical Practice ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Locally Advanced ◽  
Hematologic Toxicity ◽  
Advanced Head ◽  
Grade 3

Background and Aims To evaluate the feasibility in clinical practice of alternating chemo-radiotherapy in locally advanced head and neck cancer patients. Patients and Methods From August 1993 to April 1998 at the Division of Medical Oncology of Parma, 48 consecutive patients were observed, and 38 (79%) started the Merlano chemo-radiotherapy. The characteristics of the patients were: males (32, 84%); median age, 57 years; PS <2 (32, 84%). The primary sites were the oropharynx (18, 47%), oral cavity (8, 21%), hypopharynx (7, 19%), larynx (5, 13%); stage IV disease was present in 29 (76%) patients. Twenty-five (66%) patients were married, and 24 (63%) resided outside of the city. Results The compliance was very low: 21 patients (55%) performed all the programmed cycles of chemotherapy, whereas only 5 patients (13%) performed the chemo-radiotherapy at full doses without any delay. The objective responses were 3 (8%) complete and 21 (55%) complete plus partial responses. Failures were 2 (5%) stable disease and 2 (5%) progressive disease, and the response was not assessable in 10 (26%). The median duration of the response was 8 months. The median overall survival and the time to progression were 18 and 13 months, respectively; the 5-year overall and relapse-free survival were 36% and 26%, respectively. Nine (24%) patients were still alive as of August 30, 2001, 8 (21%) of them without progression. Twenty-six patients (68%) died with a local-regional relapse. One patient (3%) died for a second cancer. Grade 3–4 hematologic toxicity was leukopenia (n = 25, 66%) and thrombocytopenia (n = 9, 24%); grade 3–4 non-hematologic toxicity was diarrhea (n = 3, 8%) and mucositis (n = 2, 5%). Two patients (5%) died for intestinal infarction and perforation possibly related to treatment. Conclusions Compliance to the chemo-radiotherapy was very poor. The response rate was lower than that reported in clinical trials, whereas overall survival was comparable. The alternating chemo-radiotherapy is a very complex treatment that cannot be easily applied in clinical practice; a careful selection of patients is mandatory not only considering oncologic and medical criteria, but also the level of awareness of the patient and his family.

Predicitve factors of cisplatin (CDDP) discontinuation in concurrent chemoradiotherapy (CCRT) to locally advanced head and neck cancer patients.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17006-e17006
Author(s):  
Kenji Nakano ◽  
Yasuyoshi Sato ◽  
Yukiko Sato ◽  
Takashi Toshiyasu ◽  
Takao Asari ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Renal Dysfunction ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Odds Ratio ◽  
Locally Advanced ◽  
Stage Iv ◽  
High Dose ◽  
Advanced Head

e17006 Background: CCRT is a standard therapy for locally advanced head and neck cancer patients, but some patients have intolerance to high dose density of CDDP. Predictive factors for CDDP discontinuation need to be investigated for making appropriate treatment decisions. Methods: We retrospectively analyzed nonmetastatic head and neck cancer patients treated with CCRT with CDDP (80 mg/m2 per 3 weeks) from November 2005 to April 2012 in our institute. Radiation therapy was performed as three-dimensional radiotherapy or intensity-modified radiotherapy (IMRT). Results: A total of 164 patients received CCRT, of which 89 (54 %) were Stage IV;. Primary sites were as follows; oral cavity 7, oropharynx 52, hypopharynx 53, larynx 14, nasopharynx 30, paranasal sinus/nasal cavity 3, and unknown primary 5. IMRT was performed to 54 (33 %) patients. Median follow-up time was 19 months (range 1-69 months); 1-year overall survival (OS) and progression free survival (PFS) were 90 % and 78 %. Non-Stage IV; and high creatinine clearance (>70 ml/min) were associated with longer OS in Cox proportional hazard model. As for CDDP treatment, 75 (46 %) patients completed 3 cycles of CDDP, 69 (42 %) patients received 2 cycles, and 20 (12 %) patients received only 1 cycle. The main reasons for CDDP discontinuation were infection (24 patients) and renal dysfunction (18 patients). In logistic regression analysis, male sex, younger age (< 61 years) and high body mass index (BMI) (>25) were associated with 3 cycles completion of CDDP statistically significantly (p = .002, odds ratio 6.622; p = .006, odds ratio 2.602; p = .035, odds ratio 2.655, respectively). Conclusions: In CCRT to head and neck cancer patients, infection and renal dysfunction were the main reasons for CDDP discontinuation. Sex, age and BMI could be predictive of CDDP completion/discontinuation.

scholarly journals Tumour Response After Palliative Radiotherapy: Influence on Head and Neck Cancer Patients Survival

2018 ◽  
Author(s):  
Mafalda Cruz ◽  
Cláudia Sousa ◽  
Leila Khouri ◽  
Joana Brandão ◽  
Domingos Roda ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Overall Survival ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Survival Rates ◽  
Tumour Response ◽  
Palliative Radiotherapy ◽  
Complete Response

INTRODUCTION: Palliative radiotherapy provides improved quality of life in head and neck cancer patients. Little is known regarding the influence of palliative radiotherapy on locoregional control and survival rates. Our objective was to evaluate tumour response after palliative radiotherapy for head and neck cancer patients and its influence on overall survival.MATERIAL AND METHODS: Retrospective study of patients diagnosed with head and neck cancer who completed palliative radiotherapy to primary local-regional sites between January 2014 and December 2016. Tumour response patterns were evaluated following a cervical and chest computed tomography performed 4-6 weeks after the end of the treatment. Differences between groups were compared using ANOVA and Chi-square test.RESULTS: We included 53 patients in our study. Radiotherapy schemes were 50 Gy/20 fr in 35.8% of our patients, 30 Gy/10 fr (32.1%), 37.5 Gy/15 fr (18.9%) and 40 Gy/20 fr (13.2%). A percentage of 61.2% of the patients had a partial response on computed tomography and 10.2% had complete response. After a mean follow-up period of 27.2 months, mean overall survival was 9.55 months (± 9.3). There were no differences in overall survival between the four radiotherapy schemes (p = 0.41). Patients who had better tumour response on computed tomography had a propensity for longer overall survival (p = 0.011).CONCLUSION: There is no consensus regarding the choice of the optimal radiotherapy fractionation scheme used in palliative care of head and neck cancer patients. Patients with advanced incurable head and neck cancer have a poor prognosis but the addition of palliative radiotherapy provides better local-regional control of the disease with the possibility of longer survival rates.

scholarly journals Association of chemotherapy with survival in stage II colon cancer patients who received radical surgery: a retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhihao Lv ◽  
Yuqi Liang ◽  
Huaxi Liu ◽  
Delong Mo
Keyword(s):  
Colon Cancer ◽  
Overall Survival ◽  
Cancer Patients ◽  
Prediction Models ◽  
Radical Surgery ◽  
Survival Rates ◽  
Stage Ii ◽  
Survival Prediction ◽  
Stage Ii Colon Cancer ◽  
Overall Survival Rates

Abstract Background It remains controversial whether patients with Stage II colon cancer would benefit from chemotherapy after radical surgery. This study aims to assess the real effectiveness of chemotherapy in patients with stage II colon cancer undergoing radical surgery and to construct survival prediction models to predict the survival benefits of chemotherapy. Methods Data for stage II colon cancer patients with radical surgery were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (1:1) was performed according to receive or not receive chemotherapy. Competitive risk regression models were used to assess colon cancer cause-specific death (CSD) and non-colon cancer cause-specific death (NCSD). Survival prediction nomograms were constructed to predict overall survival (OS) and colon cancer cause-specific survival (CSS). The predictive abilities of the constructed models were evaluated by the concordance indexes (C-indexes) and calibration curves. Results A total of 25,110 patients were identified, 21.7% received chemotherapy, and 78.3% were without chemotherapy. A total of 10,916 patients were extracted after propensity score matching. The estimated 3-year overall survival rates of chemotherapy were 0.7% higher than non- chemotherapy. The estimated 5-year and 10-year overall survival rates of non-chemotherapy were 1.3 and 2.1% higher than chemotherapy, respectively. Survival prediction models showed good discrimination (the C-indexes between 0.582 and 0.757) and excellent calibration. Conclusions Chemotherapy improves the short-term (43 months) survival benefit of stage II colon cancer patients who received radical surgery. Survival prediction models can be used to predict OS and CSS of patients receiving chemotherapy as well as OS and CSS of patients not receiving chemotherapy and to make individualized treatment recommendations for stage II colon cancer patients who received radical surgery.

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