Long-term outcomes with concurrent carboplatin, paclitaxel, and radiation therapy in locally advanced, inoperable head and neck cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6032-6032
Author(s):  
R. L. Ferris ◽  
S. S. Agarwala ◽  
E. Cano ◽  
D. E. Heron ◽  
J. Johnson ◽  
...  
Keyword(s):  
Head And Neck ◽  
External Beam Radiotherapy ◽  
Objective Response ◽  
Locally Advanced ◽  
Tube Feeding ◽  
Stage Iv ◽  
Tube Placement ◽  
Long Term Outcomes ◽  
Brachytherapy Boost

6032 Background: Our goal was to evaluate long-term outcomes of patients with squamous cell carcinoma of the head and neck (SCCHN) treated with carboplatin, paclitaxel, and radiotherapy. Methods: We conducted a phase II trial in inoperable patients with locally advanced SCCHN. Carboplatin 100 mg/m2 and paclitaxel 40 mg/m2 were administered intravenously once a week during external beam radiotherapy (once daily, 180 cGy/fraction) for 6–7 weeks. Interstitial brachytherapy was used as a boost in selected patients with primary malignancies of the oral cavity and the oropharynx. Results: 55 patients were enrolled. 52 patients (95%) had stage IV and 51 (93%) had technically unresectable disease; 62% had an oropharyngeal primary site. 21 patients underwent brachytherapy boost. Grade 3 or 4 mucositis occurred in 30% of patients. One death occurred during treatment; it was related to complications of gastrostomy tube (G-tube) placement. Forty of 50 evaluable patients (80%) had an objective response, with a complete response rate of 52%. With a median follow-up of 69 months years for surviving patients, the 5-year progression-free survival (PFS) was 36% and the 5-year overall survival (OS) was 35%. Two of the 18 long-term survivors of >50 months were G-tube feeding dependent. Patients undergoing brachytherapy boost (n=21) had similar outcomes compared with the rest of the patients. In multivariate analysis, baseline hemoglobin levels and N stage were predictive of survival. Conclusion: Treatment with concurrent carboplatin, paclitaxel and radiation is safe and offers curative potential for poor prognosis patients with locally advanced SCCHN. No significant financial relationships to disclose.

scholarly journals Long-Term Outcomes of Personalized Stereotactic Ablative Brachytherapy for Recurrent Head and Neck Adenoid Cystic Carcinoma after Surgery or External Beam Radiotherapy: A 9-Year Study

2021 ◽  
Vol 11 (9) ◽  
pp. 839
Author(s):  
Yi Chen ◽  
Jinzhao Dai ◽  
Yuliang Jiang ◽  
Zhe Ji ◽  
Ping Jiang ◽  
...  
Keyword(s):  
Adenoid Cystic Carcinoma ◽  
Head And Neck ◽  
Local Control ◽  
External Beam Radiotherapy ◽  
Objective Response ◽  
External Beam ◽  
Long Term Outcomes ◽  
Adenoid Cystic ◽  
Recurrent Head

The management of recurrent head and neck adenoid cystic carcinoma (HNACC) remains a problematic challenge. This study aims to evaluate the long-term outcomes of personalized stereotactic ablative brachytherapy (SABT) as a salvage treatment for recurrent HNACC after surgery or external beam radiotherapy (EBRT). 21 patients with recurrent HNACC after surgery or EBRT successfully underwent iodine-125 (I-125) seed SABT from May 2011 to November 2019. The objective response rate (ORR), disease control rate (DCR), local control time (LCT), overall survival (OS), symptomatic relief and adverse events (AEs) were analyzed. Following SABT, the ORR and DCR were 85.7% and 100%, respectively. The 3-, and 5-year LCT rates were 68.8% and 55.1%, respectively, and the 3- and 5-year OS rates were 85.9% and 66.2%, respectively. Furthermore, univariate analyses showed that higher D90 (>137.1 Gy) was a strong positive prognostic factor of LCT (p < 0.05). The pain disappeared in one patient 3 months after SABT and partial pain improvement was observed in nine patients 1 to 6 months after SABT. Additionally, dyspnea was relieved in one patient with the tumor involving the trachea. The major AEs were mild intraoperative hemorrhage and skin/mucosal toxicities which were generally graded ≤2 and well-tolerated. Personalized SABT was an effective and safe alternative option for recurrent HNACC after the previous failure of surgery or EBRT. The parameter of D90 may influence the local control.

scholarly journals Long-Term Outcomes and Toxicity of Concurrent Paclitaxel and Radiotherapy for Locally Advanced Head-and-Neck Cancer

2009 ◽  
Vol 74 (4) ◽  
pp. 1040-1046 ◽  
Author(s):  
Deborah Citrin ◽  
John Mansueti ◽  
Anna Likhacheva ◽  
Linda Sciuto ◽  
Paul S. Albert ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Locally Advanced ◽  
Advanced Head ◽  
Long Term Outcomes

scholarly journals Long-term outcomes with concurrent carboplatin, paclitaxel and radiation therapy for locally advanced, inoperable head and neck cancer

2007 ◽  
Vol 18 (7) ◽  
pp. 1224-1229 ◽  
Author(s):  
S.S. Agarwala ◽  
E. Cano ◽  
D.E. Heron ◽  
J. Johnson ◽  
E. Myers ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Locally Advanced ◽  
Long Term Outcomes

The use of stereotactic radiotherapy boost to improve local control in patients with locally advanced nasopharyngeal carcinoma (NPC)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 6056-6056 ◽  
Author(s):  
Q. Le ◽  
W. Hara ◽  
S. D. Chang ◽  
H. A. Pinto ◽  
M. J. Kaplan ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Local Control ◽  
Stereotactic Radiotherapy ◽  
External Beam Radiotherapy ◽  
Locally Advanced ◽  
Stage Iv ◽  
Late Toxicity ◽  
Intracranial Extension ◽  
Temporal Lobe Necrosis

6056 Background: To determine the long term outcomes and delayed side effects in patients receiving stereotactic radiotherapy (SRT) as a boost following external beam radiotherapy (EBRT) for locally advanced NPC. Methods: 82 NPC patients received a STR boost after EBRT at our institution between 9/1992 and 5/2006. Nine patients had T1, 31 had T2, 12 had T3, and 30 had T4 tumors (1997 AJCC staging). Sixteen patients had stage II, 20 had stage III, and 46 had stage IV neoplasms. Most patients received 66 Gy of EBRT followed by a single fraction STR boost of 7–15 Gy, delivered 2–6 weeks after EBRT. 70 patients also received cisplatin-based chemotherapy delivered concurrently with and adjuvant to EBRT. Results: At median follow-up of 40.7 months for living patients (range: 6.5 –144.2 months), there was only 1 local failure in a patient with a T4 tumor. At five years, the freedom from local relapse rate was 98%, freedom from nodal relapse was 83%, freedom from distant metastasis was 68%, freedom from any relapse was 67% and overall survival was 69%. Late toxicity included unresolved V2 or V3 numbness in 2, radiation-related retinopathy in 1, carotid aneurysm in 1, and radiographic temporal lobe necrosis in 9 patients, of which 2 were symptomatic with seizures. All but one patient with temporal lobe necrosis had intracranial tumor extension at diagnosis. Conclusions: STR boost after EBRT resulted in excellent local control. However, the incidence of temporal lobe necrosis approached 11% in these patients and higher in patients with intracranial extension. Improved target delineation and dose homogeneity of radiation delivery for both EBRT and STR is important to avoid long-term complications. No significant financial relationships to disclose.

Palliative split-course hypofractionated radiotherapy for incurable mucosal squamous cell head and neck cancer: a 10 year experience

2015 ◽  
Vol 15 (1) ◽  
pp. 61-65 ◽  
Author(s):  
S. Ponnusamy ◽  
R. J. Casasola ◽  
P. G. Niblock
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Squamous Cell ◽  
Locally Advanced ◽  
Stage Iv ◽  
Neck Region ◽  
Hypofractionated Radiotherapy ◽  
Three Phases

AbstractIntroductionLocally advanced head and neck cancer can be a distressing disease due to a variety of reasons. This retrospective study looks at the tolerability and outcomes for palliative split-course hypofractionated radiotherapy for this group of patients treated in our centre.ResultsA total of 59 patients were treated with hypofractionated split-course radiotherapy for incurable mucosal squamous cell carcinoma of the head and neck region in our centre over a 10-year period. In all, 71% had stage IV disease. Radiotherapy consisted of three phases of 14·4 Gy/phase, in four to eight fractions over 4 days giving one·8–3·6 Gy/fraction. The phases were separated by 2 weeks. A total of 40 patients (63%) completed all three phases. A total of 72% patients had no acute toxicities and the palliation rate was 83% (complete and partial). Only five patients had no meaningful palliation having completed all three phases. Median duration of local control was 6 months (range: 1–63 months) and median overall survival was 8 months (range: 1–68 months). In five patients, the control was durable with no recurrence at the time of analysis with survival ranging from 6 to 57 months.ConclusionWe are the first UK centre to report with long-term data, the use of a palliative three phase regime that provides meaningful palliation with acceptable toxicities. In addition, for some patients, it has resulted in durable long-term control.

scholarly journals Long-term outcomes of pneumonectomy, back-table lung preservation, double-sleeve resection and reimplantation for advanced central lung cancer: the Oto procedure

2018 ◽  
Vol 56 (1) ◽  
pp. 213-214 ◽  
Author(s):  
Shin Tanaka ◽  
Seiichiro Sugimoto ◽  
Junichi Soh ◽  
Takahiro Oto
Keyword(s):  
Lung Cancer ◽  
Locally Advanced ◽  
Sleeve Resection ◽  
Long Term Outcomes ◽  
Short Term ◽  
Lung Preservation

Abstract The technique of pneumonectomy, back-table lung preservation, double-sleeve resection and reimplantation of basal segments (the Oto procedure) has been proposed as a useful technique for the management of locally advanced central lung cancer with short-term follow-up. We report the long-term outcomes of 5 consecutive patients who underwent the Oto procedure.

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