Evaluating predictors of relapse in locally advanced head and neck cancer patients in community oncology: Retrospective review of treatment outcomes in rural New Mexico.

2016 ◽  
Vol 34 (15_suppl) ◽  
pp. e17536-e17536
Author(s):  
Tareq Braik ◽  
Ajaz Bulbul ◽  
Prashanthi Konda ◽  
Masoud Khorsand-Sahbaie ◽  
Sadaf Rashad ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
New Mexico ◽  
Head And Neck ◽  
Treatment Outcomes ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Retrospective Review ◽  
Locally Advanced ◽  
Advanced Head ◽  
Community Oncology

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.

A comparative study of the response and toxicities in locally advanced head and neck cancer patients treated with paclitaxel, cisplatinum, 5-FU versus docetaxel, cisplatinum, 5-FU as neoadjuvant chemotherapy followed by concurrent chemoradiation.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 6089-6089
Author(s):  
Diptirani Samanta ◽  
Surendra nath Senapati ◽  
Kirti Ranjan Mohanty ◽  
Saroj Das
Keyword(s):  
Head And Neck Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Locally Advanced ◽  
Concurrent Chemoradiation ◽  
Advanced Head ◽  
Grade Ii

6089 Background: To evaluate the response and toxicity of docetaxel, cisplatinum, 5-FU vs paclitaxel, cisplatinum, 5-FU as neoadjuvant chemotherapy (NACT) followed by concurrent chemoradiation (CTRT) with weekly cisplatinum in locally advanced head and neck cancer. Methods: 40 locally advanced head and neck cancer patients who satisfied the eligibility criteria were randomized.21 patients received three cycles of NACT i.e paclitaxel (175 mg/m2) on d1, cisplatinum (30 mg/m2) and 5-FU (600 mg/m2) d2-d4 (TCF) and 19 patients received three cycles of NACT docetaxel (75 mg/m2) on d1, cisplatinum (30 mg/m2) and 5-FU (600 mg/m2) d2-d4 at three week intervals, followed by concurrent weekly cisplatinum 30 mg/m2 along with conventional external beam radiation of total tumor dose dose 66 Gy. Response was assessed after NACT and again after six weeks, three months and six months of completion of chemoradiation. Toxicities were assessed after each cycles of NACT and also weekly during CTRT and thereafter. Results: Two weeks after completion of NACT complete response (CR) in TCF was 4.76%, partial response (PR) 80.9% and no response 9.5%. However in DCF, CR was 15.78 % PR was 73.68%. 10.52% patientd died due to toxicity. With a median follow up of seven months, in TCF CR was 57.14%, PR 33.33% and no response was 4.76%, whereas in DCF CR was 78.94%, PR 10.52% and death 10.5%. On evaluation of toxicities during NACT, patients in DCF had more significant neutropenia and in TCF more incidence of neuropathy. During CTRT, in TCF grade II and III mucositis was 54%, grade II neutropenia 5.6%, and grade II anemia 5.3%. In DCF mucositis grade II and III was 49.0%, neutropenia grade II 18.7% and anemia grade II was 7.4%. Late toxicities included were comparable in both arms. Conclusions: With a median follow up of 7 months, the CR in DCF was 78.94%, superior than TCF i.e 57.14%. Neutropenia was significant in DCF and neuropathy was high in TCF. In CTRT mucositis was the commonest toxicity observed in both TCF and DCF which was not statistically significant.

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.

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