Neoadjuvant carboplatin and vinorelbine followed by chemoradiotherapy in locally advanced head and neck or oesophageal squamous cell carcinoma: A phase II study in elderly patients or patients with poor performance status

Haralabos Koussis, Annamaria Scola, Francesca Bergamo, Stefano Tonello, Umberto Basso, Paraskevi Karahontzitis, Vanna Chiarion-Sileni, Lara Pasetto, Alberto Ruol, Lucio Loreggian, Ornella Lora, Raffaele Bottin, Gino Marioni, Martin Donach, Antonio Jirillo

Research output: Contribution to journalArticle

Abstract

Background: The purpose of this study was to evaluate the efficacy and toxicity of neo-adjuvant carboplatin and vinorelbine followed by concomitant chemoradiotherapy in patients ≥70 years of age or with Karnofsky performance status (PS) 70-80, diagnosed with locally advanced head and neck (H&N) or oesophageal carcinoma. Patients and Methods: The treatment plan consisted of three courses of carboplatin AUC4 on day 1 and vinorelbine 25mg/m2 on day 1 and 8, every 21 days, followed by chemoradiotherapy. Carboplatin 100 mg/m2 was delivered weekly for the duration of the radiation therapy (70 Gy, 2 Gy/daily). Results: Thirty-five patients with an average age of 68 years (range 42-85, 16 patients ≥70 years) were treated. Twenty-seven patients (77.1%) responded to neo-adjuvant chemotherapy (2 complete and 25 partial responses). Haematological toxicity was grade 3-4 in 13 patients (37.2%), while gastrointestinal toxicity was grade 3-4 in 20 patients (57.1%). All the patients completed the chemoradiotherapy plan, with grade 4 mucositis plus febrile neutropenia in 3 patients (85%). Median time to progression (TTP) was 10.2 months, with 31.5% of patients being alive at two years. Conclusion: The regimen of neo-adjuvant carboplatin and vinorelbine followed by chemoradiotherapy is feasible and active in older (≥70 years) or low PS (Karnofsky 70-80) patients, although toxicity is not negligible and long-term outcome remains poor.

Original languageEnglish
Pages (from-to)1383-1388
Number of pages6
JournalAnticancer Research
Volume28
Issue number2 B
Publication statusPublished - Mar 2008

Keywords

  • Carboplatin
  • Elderly
  • Head and neck cancer
  • Oesophageal cancer
  • Poor performance status
  • Vinorelbine

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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