Induction chemotherapy followed by simultaneous hyperfractionated radiochemotherapy in advanced head and neck cancer: A pilot study

Barbara Jereczek-Fossa, Filippo De Braud, Maura Gasparetto, Tommaso De Pas, Nicoletta Tradati, Maria Cristina Leoaardi, Hugo Raul Marsiglia, Roberto Orecchia

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To evaluate the feasibility of induction chemotherapy followed by concomitant chemotherapy and hyperfractionated irradiation in locally advanced, inoperable head and neck cancer. Methods: A pilot study was undertaken comprising 3 cycles of cisplatinum (100 mg/m2, day 1) and 5- fluorouracil (1000 mg/m2 in continuous intravenous infusion over the first 120 h) followed by bifractionated radiotherapy applied to tumor/involved lymph nodes up to the dose of 74.4 Gy given in 2 fractions of 1.2 Gy daily for 5 days a week combined with concomitant weekly cisplatinum infusion (50 mg/m2). Results: Six patients were enrolled in the study. All of them completed the protocol therapy. Severe mucositis and myelotoxicity were the most common acute side effects observed in all and in 5 of the patients, respectively. Acute toxicity required interruption of concomitant chemotherapy in 5 cases and in 2 interruption of radiotherapy was necessary. Opioid analgesic parenteral therapy was administered in 4 patients. Three of them had to be hospitalized. One patient experienced cerebral stroke 1 day after the completion of therapy and died 7 days later. Due to high acute toxicity, patient accrual was terminated after 6 patients. At the mean follow-up of 17 months, 4 patients are alive, 3 of them are free of disease and in 1 local progression has been diagnosed. Conclusions: High acute toxicity of induction cisplatinum and 5-fluorouracil followed by concomitant cisplatinum and hyperfractionated irradiation calls for less toxic treatment schedules in locally advanced inoperable head and neck cancer.

Original languageEnglish
Pages (from-to)457-461
Number of pages5
JournalStrahlentherapie und Onkologie
Volume174
Issue number9
Publication statusPublished - Sep 1998

Keywords

  • Concomitant radiochemotherapy
  • Head and neck cancer
  • Hyperfractionated radiotherapy
  • Induction chemotherapy

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cancer Research
  • Radiological and Ultrasound Technology

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