Induction chemotherapy and radiation therapy for T4 oropharyngeal carcinoma

Nathu, Rakesh M.; Mendenhall, William M.; Parsons, James T.; Mancuso, Anthony A.; Carroll, Robert R.

doi:10.1002/(sici)1520-6823(1999)7:2<98::aid-roi5>3.0.co;2-b

Cited by 14 publications

(3 citation statements)

References 27 publications

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“…8 Thirty-nine patients received concomitant chemotherapy. Induction chemotherapy is no longer employed, and all patients who receive adjuvant chemotherapy are treated concomitantly with RT.…”

Section: Methodsmentioning

confidence: 99%

Definitive Radiotherapy for Tonsillar Squamous Cell Carcinoma

Mendenhall¹,

Morris²,

Amdur³

et al. 2006

American Journal of Clinical Oncology

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Section: Methodsmentioning

confidence: 99%

Definitive Radiotherapy for Tonsillar Squamous Cell Carcinoma

Mendenhall¹,

Morris²,

Amdur³

et al. 2006

American Journal of Clinical Oncology

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“…The CRT group showed a better DFS than did the RT group, and this difference was statistically significant. Neoadjuvant chemotherapy before radiation therapy is an effective organ-sparing strategy for patients with squamous cell carcinoma of the larynx and hypopharynx (15), and this procedure showed promise as an organ-preserving tool upon retrospective analysis of patients with T4 oropharyngeal squamous cell carcinoma at the University of Florida (16). Concurrent chemoradiation therapy has consistently produced higher rates of both local-regional control and survival compared with the rates produced by radiation therapy alone in the randomized trial studies (17～23).…”

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of the Treatment Results for Patients with Squamous Cell Carcinoma of Tonsil

Chang

Park

et al. 2005

Cancer Res Treat

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Purpose: There has been no definitive randomized study to identify the optimal therapeutic regimen for treating squamous cell carcinoma of tonsil. The purpose of this study was to retrospectively evaluate the treatment outcome according to various combinations of surgery, radiation therapy and chemotherapy.M aterials and Methods: Fifty-six patients with tonsillar carcinoma, who were treated at Seoul National University Hospital from March 1985 to August 2001, were the subjects of this study. Twenty-one patients received surgery followed by radiation therapy (SRT), 16 patients underwent radiation therapy alone (RT), and 19 patients received neoadjuvant chemotherapy and radiation therapy (CRT). The median radiation dose was 66.6 Gy for the SRT group and 70.2 Gy for the RT and CRT groups. Surgery comprised extended tonsillectomy and modified radical neck dissection of the involved neck. Cisplatin and 5-fluorouracil were used every three weeks for 3 cycles in the SRT group. The median follow-up was 73.2 months.Results: The distribution of T-stage was 4 cases of T1, 14 cases of T2, 1 case of T3 and 2 cases of T4 staging in the SRT group, 2 cases of T1, 6 cases of T2, 5 cases of T3 and 3 cases of T4 staging in the RT group and 0 cases of T1, 7 cases of T2, 9 cases of T3 and 3 cases of T4 staging in the CRT group. The distribution of N-stage was 5 cases of N0, 2 cases of N1, 13 cases of N2 and 1 case of N3 staging in the SRT group, 6 cases of N0, 5 cases of N1, 5 cases of N2 and 0 cases of N3 staging in the RT group, and 2 cases of N0, and 7 cases of N1, 9 cases of N2 and 1 case of N3 staging in the CRT group. The five-year overall survival rate (OSR) for all patients was 78% . The five-year OSR was 80% for the SRT group, 71% for the RT group, and 80% for the CRT group (p=ns). The five-year disease-free survival rate was 93% for the CRT group and 71% for the RT group (p=0.017). Four patients developed local failure and one patient failed at a regional site in the RT group, and one patient failed at a primary site in the CRT group. The five-year DFS was 84% for patients who had undergone neck dissection and 76% for patients who had not undergone neck dissection (p=ns). Treatment-related complications of grade 3 or 4 occurred in 15 patients, and the incidence of complication was not different between each of the treatment methods.Conclusion: Although the patients with more advanced T stage were included in the RT and CRT groups, the OSR was not statistically different according to the treatment methods. In the radical radiation therapy group, the addition of neoadjuvant chemotherapy showed an improvement in the disease-free survival. Because of the retrospective nature of our study and the small number of patients, this study cannot draw any definite conclusions, but it suggests that radiation therapy with chemotherapy can be a good alternative option for squamous cell carcinoma of tonsil. Controlled randomized study is necessary to confirm this hypothesis.

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“…Twice daily fractionated radiotherapy at 1.2 Gy is consistent with our long-standing institutional policy for hyperfractionated treatment of carcinoma of the head and neck regions. 7 It was therefore hypothesized that the good responses achieved in head and neck carcinomas could potentially be achieved in our lung cancer patients.…”

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confidence: 99%

Five-Year Results of a Phase II Trial of Hyperfractionated Radiotherapy and Concurrent Daily Cisplatin Chemotherapy for Stage III Non-Small-Cell Lung Cancer

Keene

Harman²,

Knauf³

et al. 2005

American Journal of Clinical Oncology

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The purpose of this study was to evaluate the 5-year results for a phase II trial of hyperfractionated radiotherapy (RT) and concurrent daily cisplatin chemotherapy. Between August 1994 and December 1999, 63 patients with stage IIIA and stage IIIB non-small-cell lung cancer were treated with RT to a dose of 69.6 Gy at 1.2 Gy twice daily with daily cisplatin at 6 mg/m. Thirty-seven patients elected to receive consolidation carboplatin and paclitaxel chemotherapy. Recurrence and survival outcomes were evaluated by Kaplan-Meier analysis. Acute and late side effects were scored by the Radiation Therapy Oncology Group (RTOG) grading system. Radiographic complete or partial tumor response was achieved in 34 of 63 (54%) of cases. Median absolute survival was 20.1 months. Median time to local recurrence and distant metastases were 10.6 and 8.6 months, respectively. Overall survival rates were 57%, 35%, and 23% at 1, 3, and 5 years, respectively. Survival was significantly greater for patients receiving consolidation chemotherapy (50% versus 20% at 3 years). Only 5 patients (7%) experienced Grade 3 or 4 esophagitis. There were 16 cases of Grade 1 or 2 pneumonitis; steroid therapy resolved symptoms in 9 patients. This regimen of hyperfractionated RT and chemotherapy achieved significant response, and 5-year survival rates with acceptable toxicity.

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Induction chemotherapy and radiation therapy for T4 oropharyngeal carcinoma

Cited by 14 publications

References 27 publications

Definitive Radiotherapy for Tonsillar Squamous Cell Carcinoma

Definitive Radiotherapy for Tonsillar Squamous Cell Carcinoma

Retrospective Analysis of the Treatment Results for Patients with Squamous Cell Carcinoma of Tonsil

Five-Year Results of a Phase II Trial of Hyperfractionated Radiotherapy and Concurrent Daily Cisplatin Chemotherapy for Stage III Non-Small-Cell Lung Cancer

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