scholarly journals Concurrent chemoradiotherapy with docetaxel, cisplatin, and 5-fluorouracil for T3 N0 glottic carcinoma without vocal cord fixation

2021 ◽  
Author(s):  
Ryo Toya ◽  
Takahiro Watakabe ◽  
Daizo Murakami ◽  
Tomohiko Matsuyama ◽  
Tetsuo Saito ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Concurrent Chemoradiotherapy ◽  
Tumor Regression ◽  
Survival Rates ◽  
Local Treatment ◽  
Tumor Control ◽  
Glottic Carcinoma ◽  
Distant Failure ◽  
Reasonable Approach ◽  
Grade 3

Abstract Background Reports on the treatment results of chemoradiotherapy (CRT) for T3 N0 glottic carcinoma without vocal cord fixation are limited. We retrospectively evaluated the efficacy and toxicity of concurrent chemoradiotherapy (CCRT) with docetaxel, cisplatin, and 5-fluorouracil (TPF) for T3 N0 glottic carcinoma without vocal cord fixation. Methods Twenty-five patients were treated with TPF-CCRT. The chemotherapy consisted one or two cycles of TPF as follows: docetaxil (50 mg/m2), cisplatin (60 mg/m2), and 5-FU (600 mg/m2/day for 5 days). RT was delivered with a once-daily fraction of 2 Gy without elective nodal irradiaion (ENI). After the RT of 40 Gy and one cycle of chemotherapy, five patients (20%) were judged as having no tumor regression and underwent surgery. The remaining 20 patients underwent RT with a median total dose of 66 Gy. Results Of the five patients who underwent surgery after the delivery of 40 Gy, two showed residual carcinoma pathologically and the other three were confirmed to have complete pathological response to the treatment. During the follow-up period after a series of therapies, one patient had local failure. None of the patients exhibited regional or distant failure. The 5-year local control, laryngeal preservation, and overall survival rates were 87%, 92%, and 95%, respectively. Neutropenia was frequently observed during the treatment but was manageable in all the cases. No acute toxicities of grade 5 or late toxicities ≥ grade 3 were observed. Conclusions In this study, TPF-CCRT provided excellent tumor control with acceptable toxicities. Intensive local treatment with CCRT while omitting ENI is a reasonable approach for T3 N0 glottic carcinoma without vocal cord fixation.

DeCIDE: A phase III randomized trial of docetaxel (D), cisplatin (P), 5-fluorouracil (F) (TPF) induction chemotherapy (IC) in patients with N2/N3 locally advanced squamous cell carcinoma of the head and neck (SCCHN).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 5500-5500 ◽  
Author(s):  
Ezra E. W. Cohen ◽  
Theodore Karrison ◽  
Masha Kocherginsky ◽  
Chao H Huang ◽  
Mark Agulnik ◽  
...  
Keyword(s):  
Locally Advanced ◽  
Survival Rates ◽  
Phase Iii ◽  
High Survival ◽  
Open Label ◽  
Free Survival ◽  
Prior Therapy ◽  
Distant Failure ◽  
Grade 3

5500 Background: IC is associated with lower distant failure (DF) rates in SCCHN but an improvement in overall survival (OS) has not been validated. The goal of this trial was to determine whether IC prior to chemoradiotherapy (CRT) improves survival compared to CRT alone. Methods: In this phase 3, open-label trial, subjects with pathologically confirmed SCCHN; N2/N3 disease without metastases; no prior therapy; KPS ³ 70%; and intact organ function were randomized to CRT alone (CRT arm) [5 days of D (25 mg/m2), F (600 mg/m2), hydroxyurea (500 mg BID), and RT (150 cGy BID) followed by a 9 day break] or to 2 cycles of IC [D (75 mg/m2), P (75 mg/m2), F (750 mg/m2 day 1-5)] followed by the same CRT (IC arm). Primary endpoint was OS. Secondary endpoints included DF free survival, failure pattern, and recurrence-free survival (RFS). 280 subjects provided 80% power to detect a hazard ratio HR=0.5 for OS (a=0.05). Results: 280 subjects were accrued from 2004-09 with minimum follow-up 24 months. Of 142 patients randomized to IC, 91% received 2 cycles and 87% continued to CRT. Treatment adherence during CRT was high for docetaxel and hydroxyurea, but fewer than 75% of the patients received target dose of 5FU in both arms. RT was delivered without major deviations in 94% and 95% of patients on IC and CRT arms, respectively. The most common grade 3-4 toxicities during IC were febrile neutropenia (9%) and mucositis (8%), and during CRT (both arms combined) they were mucositis (45%), dermatitis (19%), and leukopenia (17%). Only grade 3-4 leukopenia and neutropenia rates were significantly higher in IC (p=0.002 and p=0.02, respectively). Table shows efficacy. Conclusions: High survival rates were observed in both arms. Further analysis and follow-up may provide insight into why the significant decrease in DF did not translate into improved OS. [Table: see text]

scholarly journals Concurrent Chemoradiotherapy With Docetaxel, Cisplatin, and 5-Fluorouracil for T3 N0 Glottic Carcinoma Without Vocal Cord Fixation

2021 ◽  
Vol 42 (1) ◽  
pp. 205-209
Author(s):  
RYO TOYA ◽  
TAKAHIRO WATAKABE ◽  
DAIZO MURAKAMI ◽  
TOMOHIKO MATSUYAMA ◽  
TETSUO SAITO ◽  
...  
Keyword(s):  
Vocal Cord ◽  
Concurrent Chemoradiotherapy ◽  
Glottic Carcinoma

Weekly Carboplatin and Paclitaxel Followed by Concomitant Paclitaxel, Fluorouracil, and Hydroxyurea Chemoradiotherapy: Curative and Organ-Preserving Therapy for Advanced Head and Neck Cancer

2003 ◽  
Vol 21 (2) ◽  
pp. 320-326 ◽  
Author(s):  
Everett E. Vokes ◽  
Kerstin Stenson ◽  
Fred R. Rosen ◽  
Merrill S. Kies ◽  
Alfred W. Rademaker ◽  
...  
Keyword(s):  
Overall Survival ◽  
Induction Chemotherapy ◽  
Systemic Disease ◽  
Survival Rates ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Outcome Data ◽  
Failure Rates ◽  
Distant Failure ◽  
Grade 3

Purpose: The paclitaxel, fluorouracil, and hydroxyurea regimen of paclitaxel, infusional fluorouracil, hydroxyurea, and twice-daily radiation therapy (TFHX) administered every other week has resulted in 3-year survival rates of 60% of stage IV patients. Locoregional and distant failure rates were 13% and 23%, respectively. To reduce distant failure rates, we added a brief course of induction chemotherapy to TFHX. Patients and Methods: Sixty-nine patients received six weekly doses of carboplatin (AUC2) and paclitaxel (135 mg/m2) followed by five cycles of TFHX. Results: Ninety-six percent had stage IV disease. Response to induction chemotherapy was partial response 52% and complete response (CR) 35%. Symptomatically, there was a significant reduction in mouth and throat pain. The most common grade 3 or 4 toxicity was neutropenia (36%). Best response following completion of TFHX was CR in 83%. Toxicities of TFHX consisted of grade 3 or 4 mucositis (74% and 2%) and dermatitis (47% and 14%). At a median follow-up of 28 months, locoregional or systemic disease progression were each noted in five patients. The overall 3-year progression-free survival was 80% (95% confidence interval [CI], 71% to 90%), and the 2- and 3-year overall survival rates were 77% (95% CI, 66% to 87%) and 70% (95% CI, 59% to 82%), respectively. At 12 months, five patients were completely feeding-tube dependent. Conclusion: Administration of carboplatin and paclitaxel before TFHX chemoradiotherapy results in high response activity and may decrease distant failure rates. Overall survival, progression, and organ preservation/functional outcome data support definitive evaluation of this approach.

scholarly journals Late Toxicities, Failure Patterns, Local Tumor Control, and Survival of Esophageal Squamous Cell Carcinoma Patients After Chemoradiotherapy With a Simultaneous Integrated Boost: A 5-Year Phase II Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Chuangzhen Chen ◽  
Jianzhou Chen ◽  
Ting Luo ◽  
Siyan Wang ◽  
Hong Guo ◽  
...  
Keyword(s):  
Overall Survival ◽  
Survival Rates ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Local Tumor ◽  
Integrated Boost ◽  
Grade 3 ◽  
Overall Survival Rates

PurposeWe aimed to evaluate the long-term outcomes of concurrent chemoradiotherapy (CCRT) with a simultaneous integrated boost (SIB) of radiotherapy for esophageal squamous cell carcinoma (ESCC).Methods and MaterialsEighty-seven patients with primary ESCC enrolled in this phase II trial. The majority (92.0%) had locoregionally advanced disease. They underwent definitive chemoradiotherapy. The radiotherapy doses were 66 Gy for the gross tumor and 54 Gy for the subclinical disease. Doses were simultaneously administered in 30 fractions over 6 weeks. The patients also underwent concurrent and adjuvant chemotherapy, which comprised cisplatin and fluorouracil. The study end points were acute and late toxicities, first site of failure, locoregional tumor control, and overall survival rates.ResultsThe median follow-up time was 65.7 (range, 2.2-97.5) months for all patients and 81.5 (range, 19.4-97.5) months for those alive. There were 17 cases (19.5%) of severe late toxicities, including four cases (4.6%) of grade 5 and seven (8.0%) of grade 3 esophageal ulceration, four (4.6%) of grade 3 esophageal stricture, and two (2.3%) of grade 3 radiation-induced pneumonia. Twenty-three (26.4%) patients had locoregional disease progression. Most (86.7%) locally progressive lesions were within the dose-escalation region in the initial radiation plan, while majority of the recurrent lymph nodes were found out-of-field (83.3%) and in the supraclavicular region (75.0%). The 1-, 2-, 3-, and 5-year locoregional tumor control and overall survival rates were 79.2%, 72.4%, 72.4%, 70.8%, and 82.8%, 66.6%, 61.9%, 58.4%, respectively. Incomplete tumor response, which was assessed immediately after CCRT was an independent risk predictor of disease progression and death in ESCC patients.ConclusionsCCRT with SIB was well tolerated in ESCC patients during treatment and long-term follow-up. Moreover, patients who underwent CCRT with SIB exhibited improved local tumor control and had better survival outcomes compared to historical data of those who had standard-dose radiotherapy.

Phase II study of concurrent S-1/cisplatin and radiation therapy in locally advanced or metastatic esophageal cancer

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14154-14154
Author(s):  
S. Cho ◽  
H. Shim ◽  
J. Ahn ◽  
D. Yang ◽  
Y. Kim ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Concurrent Chemoradiotherapy ◽  
Tumor Regression ◽  
Locally Advanced ◽  
Economic Problem ◽  
Pathologic Response ◽  
End Point ◽  
First Line Therapy ◽  
History Of ◽  
Grade 3

14154 Background: Although 5-FU and cisplatin had been widely used as radiosensitizer, the toxicities such as mucositis or bone marrow suppression were problematic. In this study, 5-FU was replaced with S-1. The primary end point of this study was to define the safety and the secondary end point was to evaluate the pathologic response and clinical efficacy as the first line therapy in locally advanced or metastatic esophageal cancer. Methods: Patients with locally advanced or metastatic esophageal cancer without history of previous chemotherapy or radiotherapy were eligible. Cisplatin was given intravenously with 75 mg/m2 on day 1 every 3 weeks. S-1 was administered at the dose of 80 mg/m2/day orally divided two times for 2 weeks followed by 1 week rest. Radiotherapy was started concomittently at day 1, total dose of 5040 cGY for 6 weeks. During radiotherapy, patients received 2 cycles of chemotherapy. Results: From May 2004 to Aug 2005, 33 patients were enrolled into this study. 6 patients were dropped out due to poor compliance (3), economic problem (2) and TEF (1) during treatment. 27 patients were evaluable for response and toxicity. The median age was 66 years (range, 54–82). Clinical response was 77.8% (21 pts) and pathologic response was shown in 29.6% (8 pts). The improvement of dysphagia was shown in 22 patients (81.5%). There were 7 (25.9%) pts with grade 3 neuropenia. Grade 3–4 odynophagia during concurrent chemoradiotherapy was observed only one patient. Conclusions: The concurrent chemoradiotherapy combined with S-1 and cisplatin was well tolerated and effective in advanced esophageal cancer to relieve obstructive symptoms and tumor regression. No significant financial relationships to disclose.

scholarly journals Brachytherapy for retinoblastoma: a 13 year experience

2021 ◽  
Vol 11 (2) ◽  
pp. 5-12
Author(s):  
A.  A. Yarovoy ◽  
V.  A. Yarovaya ◽  
E.  S. Kotova ◽  
T.  L. Ushakova ◽  
A.  V. Golanov ◽  
...  
Keyword(s):  
Tumor Regression ◽  
Local Treatment ◽  
Local Tumor Control ◽  
Tumor Control ◽  
Effective Treatment Modality ◽  
Strontium 90 ◽  
Radiation Induced ◽  
The Mean ◽  
Complete Tumor

Brachytherapy (BT) is a method of radiation therapy with radioactive source contacting the tumor. It was proposed by P. Moore and H. Stallard in 1929. Despite those 50 years of experience with the use of BT in ophthalmic oncology, there are only a few studies on the use of Ru-106 BT for retinoblastoma (RB), and no publications on the use of Sr-90 BT have been found.Purpose. To present our own experience with the use of ruthenium and strontium ophthalmic applicators for BT in retinoblastoma.Materials and methods. 120 patients (137 eyes and 194 RB foci) received BT as a local treatment in the period from 2007 to 2020. At the time of treatment the age of the patients varied from 4 to 109 months (mean age 26 months). In 32% of cases (44 eyes) there were monofocal lesions, and in 68% of cases (93 eyes) — multifocal. In 36 cases (30%) BT was performed in the single eye. 79 patients (87 eyes) were treated with the use of ruthenium ophthalmic applicators (OAs), 25 patients (26 eyes) — with the use of strontium OAs, and for the treatment of 16 patients (24 eyes) both ruthenium and strontium OAs were used.Results. Clinically complete tumor regression was achieved in 62 % of cases (120 foci), partial tumor regression — in 31% of cases (60 foci). In 6% of cases (12 foci) continuous tumor growth was observed, and tumor recurrence occurred in 1% of cases (2 foci) within 4 to 6 months after BT. Local tumor control was achieved in 93% of cases.The single eyes were preserved in 92% of cases. BT complications of different intensity were reported in 38% of cases (46 patients — 49 eyes) with the mean follow-up duration of 55 months (3 to 157 months). In 92 % of cases (42 patients — 45 eyes) complications were associated with the use of ruthenium OAs, and only in 8% of cases (4 patients — 4 eyes) — with the use of strontium OAs. Risk factors for radiation-induced complications were identified: focus size (height more than 2.5 mm [P =0.0005], extension more than 7.3 mm [P <0,0001]), sclera dose more than 626 Gr (P = 0,0002), and the central localization of the tumor (P <0.0001).Conclusions. Ruthenium-106 and strontium-90 brachytherapy is a highly effective treatment modality for the management of RB.

Induction chemotherapy followed by alternating chemo-radiotherapy in advanced undifferentiated nasopharyngeal carcinoma (UNPC)

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 15508-15508
Author(s):  
A. Ponzanelli ◽  
V. Vigo ◽  
A. Bacigalupo ◽  
M. Marcenaro ◽  
M. Benasso
Keyword(s):  
Febrile Neutropenia ◽  
Induction Chemotherapy ◽  
Survival Rates ◽  
Haematological Toxicity ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Response Assessment ◽  
Induction Phase ◽  
Distant Failure ◽  
Grade 3

15508 Background: Concomitant chemo-radiotherapy is the standard treatment for advanced UNPC. Induction chemotherapy may improve the results further by enhancing both locoregional and distant control. Methods: Fifty patients with previously untreated, locoregionally advanced UNPC were initially treated with 3 courses of epidoxorubicin, 90 mg/mq, day 1 and cisplatin, 40 mg/mq, days 1 and 2, every 3 weeks. After a radiological and clinical response assessment patients underwent 3 courses of cisplatin, 20 mg/mq/day, days 1–4 and fluorouracil, 200 mg/mq/day, days 1–4, i.v. bolus, (weeks 1,4,7) alternated to 3 splits of radiation (week 2–3, 5–6, 8–9-10), with a standard fractionation, up to 70 Gy. Histology was WHO type 1 in 1 pt (2%), WHO type 2 in 10 pt (20%), WHO type 3 in 39 pts (78%). All patients had stage IV disease (UICC 1992). Results: All the patients are evaluable for toxicity and response. All but one received 3 cycles of induction chemotherapy. Toxicities from induction chemoyherapy were: 2% grade 3 or 4 mucositis, 22% grade 3 or 4 nausea/vomiting, 6% grade 3 or 4 haematological toxicity and one episode of febrile neutropenia. At the end of induction phase 12% of CRs, 84% of PRs and 4% of SD were recorded. All patients but two had the planned number of chemotherapy courses in the alternating phase and all but one received the planned radiation dose. Toxicities from alternating chemo-radiotherapy were: 28% grade 3 or 4 mucositis, 8% grade 3 or 4 nausea/vomiting, 24% grade 3 or 4 haematological toxicity with no episodes of febrile neutropenia. At the final response evaluation 86% of CRs and 14% of PRs were observed. At a median follow up of 39 months, 14% of patients had locoregional failure, 20% had distant failure and 2% both. The 4-year actuarial progression free survival and overall survival rates were 71% and 81%. Conclusions: Treatment of locoregionally advanced UNPC with induction chemotherapy followed by alternating chemo-radiotherapy is feasible and patients’ compliance is optimal. 4-year outcomes seems better than those reported with concomitant chemo-radiotherapy alone. No significant financial relationships to disclose.

Neoadjuvant chemotherapy followed by concurrent chemoradiotherapy versus concurrent chemoradiotherapy alone in locoregionally advanced nasopharyngeal carcinoma: A phase III multicentre randomised controlled trial.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6005-6005
Author(s):  
Ming-Yuan Chen ◽  
Su-Mei Cao ◽  
Qi Yang ◽  
Ling Guo ◽  
Hai-Qiang Mai ◽  
...  
Keyword(s):  
Overall Survival ◽  
Nasopharyngeal Carcinoma ◽  
Neoadjuvant Chemotherapy ◽  
Concurrent Chemoradiotherapy ◽  
Statistical Significance ◽  
Disease Free Survival ◽  
Phase Iii ◽  
Tumor Control ◽  
Free Survival ◽  
Grade 3

6005 Background: The role of neoadjuvant chemotherapy (NACT) for locoregionally advanced nasopharyngeal carcinoma (NPC) is unclear. We aimed to evaluate the feasibility and efficacy of NACT followed by concurrent chemoradiotherapy (CCRT) versus CCRT alone in locoregionally advanced NPC. Methods: Patients with stage III-IVB (excluding T3N0-1) NPC were randomly assigned to receive NACT followed by CCRT (investigational arm) or CCRT alone (control arm). Both arms were treated with 80 mg/m² cisplatin every three weeks concurrently with radiotherapy. The investigational arm received cisplatin (80 mg/m² d1) and fluorouracil (800 mg/m² civ d1-5) every three weeks for two cycles before CCRT. The primary endpoint was disease-free survival (DFS) and distant metastasis-free survival (DMFS). Secondary endpoint was overall survival (OS). Results: 476 patients were randomly assigned to the investigational (n = 238) and control arms (n = 238). The investigational arm achieved higher 3-year DFS rate (82.0%, 95% CI = 0.77-0.87) than the control arm (74.1%, 95% CI = 0.68-0.80, P = 0.028). The 3-year DMFS rate was 86.0% for the investigational arm versus 82.0% for the control arm, with marginal statistical significance (P = 0.056). However, there were no statistically significant differences in OS or locoregional relapse-free survival (LRRFS) rates between two arms (OS: 88.2% vs 88.5%, P = 0.815; LRRFS: 94.3% vs 90.8%, P = 0.430). The most common grade 3–4 toxicity during NACT was neutropenia (16.0%). During CCRT, the investigational arm experienced statistically significantly more grade 3–4 toxicities (P < 0.001). Conclusions: NACT improved tumor control compared with CCRT alone in locoregionally advanced NPC, particularly at distant sites. However, there was no early gain in overall survival. Longer follow-up is needed to determine the eventual therapeutic efficacy. Clinical trial information: NCT00705627.

scholarly journals Radiotherapy in nodal oligorecurrent prostate cancer

2021 ◽  
Author(s):  
Michael Pinkawa ◽  
Daniel M. Aebersold ◽  
Dirk Böhmer ◽  
Michael Flentje ◽  
Pirus Ghadjar ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Literature Review ◽  
Survival Rates ◽  
Local Treatment ◽  
Progression Free Survival ◽  
Nodal Metastasis ◽  
Stereotactic Ablative Radiotherapy ◽  
Current Standard ◽  
Free Survival ◽  
Systemic Treatments

Abstract Objective The current article encompasses a literature review and recommendations for radiotherapy in nodal oligorecurrent prostate cancer. Materials and methods A literature review focused on studies comparing metastasis-directed stereotactic ablative radiotherapy (SABR) vs. external elective nodal radiotherapy (ENRT) and studies analyzing recurrence patterns after local nodal treatment was performed. The DEGRO Prostate Cancer Expert Panel discussed the results and developed treatment recommendations. Results Metastasis-directed radiotherapy results in high local control (often > 90% within a follow-up of 1–2 years) and can be used to improve progression-free survival or defer androgen deprivation therapy (ADT) according to prospective randomized phase II data. Distant progression after involved-node SABR only occurs within a few months in the majority of patients. ENRT improves metastases-free survival rates with increased toxicity in comparison to SABR according to retrospective comparative studies. The majority of nodal recurrences after initial local treatment of pelvic nodal metastasis are detected within the true pelvis and common iliac vessels. Conclusion ENRT with or without a boost should be preferred to SABR in pelvic nodal recurrences. In oligometastatic prostate cancer with distant (extrapelvic) nodal recurrences, SABR alone can be performed in selected cases. Application of additional systemic treatments should be based on current guidelines, with ADT as first-line treatment for hormone-sensitive prostate cancer. Only in carefully selected patients can radiotherapy be initially used without additional ADT outside of the current standard recommendations. Results of (randomized) prospective studies are needed for definitive recommendations.

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