Preoperative chemoradiation coupled with aggressive resection as needed ensures near total control in advanced head and neck cancer

Wanebo, Harold J.; Chougule, Prakash; Akerley, Wallace; Koness, R. James; McRae, Robert G.; Nigri, P.; Leone, Louis A.; Ready, Neal; Safran, Howard; Webber, Banice M.; Cole, Bernard F.

doi:10.1016/s0002-9610(97)00167-0

Cited by 24 publications

(18 citation statements)

References 24 publications

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“…Although many patients treated with chemoradiation alone could have been medically inoperable, the fact that no long-term survivors could be observe among patients with Stage III disease do not favor this approach. These findings are similar to what has been described with the use of taxanebased chemotherapy and conformal radiation in head and neck malignancies [29,30].…”

Section: Discussionsupporting

confidence: 89%

Esophageal cancer: Outcomes of surgery, neoadjuvant chemotherapy, and three‐dimension conformal radiotherapy

Fréchette

Buck

Chung

et al. 2004

Journal of Surgical Oncology

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Neoadjuvant chemotherapy and radiation are being utilized with increasing frequency in the multimodal treatment of esophageal cancer, although their effects on morbidity, mortality, and survival remain unclear. The objective of this study was to determine the outcome of multimodal treatment in patients with localized esophageal cancer treated at a single institution. Between 1995 and 2002, 118 patients underwent treatment for localized esophageal cancer, utilizing surgery alone, chemoradiation alone, or surgery following neoadjuvant chemoradiation. There was no statistically significant difference in morbidity, mortality, or length of stay between the patients who received multimodal therapy when compared to surgery alone. A surgical resection after down-staging was possible in 9 out of 28 patients (32%) with a clinically non-resectable tumor (T4 or M1a). Forty-seven percent of the patients who received neoadjuvant therapy had a complete pathologic response with a 3-year survival of 59% as compared to only 20 months in those patients who did not achieve a complete response (P = 0.037). Neoadjuvant chemotherapy administered concomitantly with conformal radiotherapy can be performed safely in the treatment of esophageal cancer, without increasing the operative morbidity, mortality, or length of stay. The higher complete response rates to neoadjuvant treatment (as compared to other reports) may be due to the use of three-dimensional conformal radiation therapy or the novel use of weekly carboplatin and paclitaxel.

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Section: Discussionsupporting

confidence: 89%

Esophageal cancer: Outcomes of surgery, neoadjuvant chemotherapy, and three‐dimension conformal radiotherapy

Fréchette

Buck

Chung

et al. 2004

Journal of Surgical Oncology

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“…10 Many Phase II studies reported a high local control rate and improved survival with chemoradiation in patients with inoperable head and neck disease. [11][12][13] Long-term survival ranging from 52-76% at 4 -5 years was reported in these trials. Randomized Phase III studies comparing concurrent chemotherapy and radiation with radiation therapy alone also reported a statistically significantly improved survival rate for the combined modalities.…”

mentioning

confidence: 92%

Combined chemotherapy and radiation therapy for head and neck malignancies

Nguyen

Sallah

Karlsson

et al. 2002

Cancer

197

167

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Acute side effects of combined chemotherapy and radiation therapy usually were found to resolve after treatment. Long-term morbidity is substantial because of xerostomia and severe dysphagia. However, preliminary studies suggest that because of organ preservation, patients may achieve a better quality of life after chemoradiation compared with the conventional use of surgery and postoperative radiation.

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“…The pathologic findings at neck dissection have led many investigators to abandon the practice of interval surgery for neck disease. 3,10 Primary site head and neck cancer present after aggressive chemoradiotherapy obviously demonstrates a biologically aggressive disease, frequently refractory to any treatment. Our data set is small and heavily biased by very advanced primary site disease.…”

Section: Discussionmentioning

confidence: 99%

Interval pathologic assessments in patients treated with concurrent hyperfractionated radiation and intraarterial cisplatin (HYPERRADPLAT)

et al. 2002

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Preoperative chemoradiation coupled with aggressive resection as needed ensures near total control in advanced head and neck cancer

Cited by 24 publications

References 24 publications

Esophageal cancer: Outcomes of surgery, neoadjuvant chemotherapy, and three‐dimension conformal radiotherapy

Esophageal cancer: Outcomes of surgery, neoadjuvant chemotherapy, and three‐dimension conformal radiotherapy

Combined chemotherapy and radiation therapy for head and neck malignancies

Interval pathologic assessments in patients treated with concurrent hyperfractionated radiation and intraarterial cisplatin (HYPERRADPLAT)

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