Multimodal intensification therapy for previously untreated advanced resectable squamous cell carcinoma of the oral cavity, oropharynx, or hypopharynx
- 12 June 2002
- Vol. 94 (12) , 3169-3178
- https://doi.org/10.1002/cncr.10571
Abstract
An intensified treatment regimen for previously untreated Stage III and IV resectable oral cavity, oropharyngeal, or hypopharyngeal squamous cell carcinoma was analyzed to assess disease control, patient compliance, and toxicity. Forty three patients with previously untreated, advanced, resectable squamous cell carcinoma of the oral cavity, oropharynx, or hypopharynx were enrolled in a prospective Phase II institutional clinical trial at a tertiary care comprehensive cancer center. This regimen was a continuum of multimodal treatment in a contracted time interval. It included preoperative slightly accelerated hyperfractionated radiotherapy with concurrent cisplatin, followed immediately with surgery and intraoperative radiotherapy, and completed with early postoperative weekly paclitaxel (beginning on Day 6 after surgery), two additional cisplatin cycles, and concurrent once daily radiotherapy beginning on Day 28 after surgery. The current trial was designed to reduce the toxicity of the systemic therapy while maintaining or improving locoregional/distant disease control and patient compliance. There were 43 patients enrolled, and the range of time at risk was 2.6 to 24.7 months (median, 14.6 months). Of the 43 registered patients, 43 were evaluable. The locoregional (100%) and systemic (93%) disease control rates were excellent, with low rates of patient noncompliance (21%) and reduced levels of toxicity. An intensive treatment regimen that improves disease control and treatment compliance is clearly feasible for this patient population. Future plans include modifications to continue to reduce toxicity and expansion to a multi-center Phase II trial to determine if the single institutional results can be duplicated.Keywords
This publication has 26 references indexed in Scilit:
- Chemo-radiotherapy, as compared to radiotherapy alone, significantly increases disease-free and overall survival in head and neck cancer patients after surgery: results of EORTC phase III trial 22931International Journal of Radiation Oncology*Biology*Physics, 2001
- Cancer statistics, 1999CA: A Cancer Journal for Clinicians, 1999
- Hyperfractionated Irradiation with or without Concurrent Chemotherapy for Locally Advanced Head and Neck CancerNew England Journal of Medicine, 1998
- Postoperative radiotherapy with concurrent cisplatin appears to improve locoregional control of advanced, resectable head and neck cancers: RTOG 88-24International Journal of Radiation Oncology*Biology*Physics, 1997
- Intensified Regimen for Advanced Head and Neck Squamous Cell CarcinomasJAMA Otolaryngology–Head & Neck Surgery, 1997
- IORT Using Electron Beam or HDR Brachytherapy for Previously Unirradiated Head and Neck CancersPublished by S. Karger AG ,1997
- Five-Year Update of a Randomized Trial of Alternating Radiotherapy and Chemotherapy Compared With Radiotherapy Alone in Treatment of Unresectable Squamous Cell Carcinoma of the Head and NeckJNCI Journal of the National Cancer Institute, 1996
- Adjuvant chemotherapy for resectable squamous cell carcinomas of the head and neck: Report of intergroup study 0034International Journal of Radiation Oncology*Biology*Physics, 1992
- Do Otolaryngologist-Head and Neck Surgeons and/or Chemotherapy Have a Role in the Treatment of Head and Neck Cancer?JAMA Otolaryngology–Head & Neck Surgery, 1991
- Preoperative chemotherapy in advanced resectable head and neck cancer: Final report of the southwest oncology groupThe Laryngoscope, 1988