Combined therapy for stage III-IV head and neck cancer: preliminary results.

As part of a combined modality treatment program using chemotherapy, surgery, and/or radiotherapy, 25 patients with previously untreated stage III or IV head and neck cancer received initial combination chemotherapy. Pathologically confirmed complete remission was noted in nine patients (36%). The overall objective major response rate (with all patients included in analysis) was 68%. The chemotherapy regimen included bleomycin, cisplatin, vinblastine, methotrexate, and 5-fluorouracil. A novel concept of drug scheduling was used, based on chemotherapy-induced improvement in RBC deformability. The underlying concept is that improved RBC deformability results in improved capillary blood flow and thereby, increased drug delivery to tumor cells. Treatment resulted in moderate hematologic and renal toxicity with no treatment-related deaths. This exceptionally high, pathologically confirmed complete response rate will hopefully provide a mechanism by which combined modality therapy can adequately be tested for its ability to prolong survival of patients with advanced head and neck cancer.

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Patterns of relapse in locally advanced head and neck cancer patients who achieved complete remission after combined modality therapy

Plastic & Reconstructive Surgery ◽

10.1097/00006534-198607000-00083 ◽

1986 ◽

Vol 78 (1) ◽

pp. 137

Author(s):

Hal G. Bingham

Keyword(s):

Head And Neck Cancer ◽

Complete Remission ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Combined Modality Therapy ◽

Locally Advanced ◽

Advanced Head ◽

Combined Modality

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Integration of chemotherapy into a combined modality treatment plan for head and neck cancer: A review

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/0360-3016(81)90442-9 ◽

1981 ◽

Vol 7 (2) ◽

pp. 229-242 ◽

Cited By ~ 43

Author(s):

John H. Glick ◽

Samuel G. Taylor

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Treatment Plan ◽

Combined Modality Treatment ◽

Combined Modality

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Concurrent chemoradiotherapy (crt) with weekly docetaxel (d) for advanced head and neck cancer

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.15516 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 15516-15516

Author(s):

G. López-Argumedo ◽

G. López-Vivanco ◽

R. Fernández ◽

I. Díaz de Corcuera ◽

A. Sancho ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Head And Neck Cancer ◽

Cell Carcinoma ◽

Head And Neck ◽

Neck Cancer ◽

Squamous Cell ◽

Response Rate ◽

Stage Iii ◽

Advanced Head ◽

Percutaneous Gastrostomy

15516 Background: Concomitant CRT has become a standard treatment for advanced head and neck cancer. The aim of this study was to evaluate the efficacy and toxicity of concurrent CRT with D in patients (pts) with advanced squamous cell carcinoma of head and neck (SCCHN). Methods: Patients with untreated and unresectable stage III or IV (M0) squamous cell carcinoma of head and neck were included. Treatment consisted of D 20 mg/m2 weekly with concomitant radiotherapy 70 Gy (2 Gy per day, 7 weeks). Results: From September 03 to October 05, sixty-four pts with advanced SCCHN, were recruited. Gender: 61 male, 3 female. Mean age: 56.5 years old (range 42–77). ECOG PS 0/1/2: 0/57/7. Primary sites of disease: oral cavity 8, oropharynx 26, hypopharynx 15 and larynx 15. Stage III 16 pts and stage IV 48 pts. Compliance: 393 administrations of D were given, median 6, mean 6 (range 1–8). Fifty-five pts (86%) completed the radiotherapy dose planned (mean dose of RT was 66 Gy). One refused more treatment with D after first administration. Nineteen pts required supportive percutaneous gastrostomy or nasogastric tubes previously or during therapy. Grade 2/3/4 toxicity per patient: anemia 4/2/0, mucositis 21/24/0, dermatitis 21/20/0. Neither thrombopenia nor neutropenia were observed. Four pts died of aspiration pneumonia during treatment, one of gastric perforation and two of unknown causes. Fifty-six pts were evaluable for response: CR 28 (44%), PR 23 (36%), SD 2 (3%), PD 3 (5%), with an overall response rate of 80%. Median overall survival was 74.86 weeks (95% CI: 40.40–109.32) and median progression free survival was 48 weeks (95% CI: 18.80–77.20). With a median follow up of 40 weeks 34 pts (53%) were alive and 21 of them (33%) remained free of disease. Conclusions: Concurrent weekly D with conventional radiotherapy showed a high response rate. Toxicity was manageable and allowed maintaining radiotherapy administration. Taking into account poor prognostic factors of our series, survival results seem promising. No significant financial relationships to disclose.

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