Sequential and synchronous chemo-radiotherapy in the management of locally advanced carcinoma of the head and neck

P. Antognoni, G. Camesasca, C. Bianchi, G. Nicoletti, E. Villa

Research output: Contribution to journalArticle

Abstract

Thirty-nine consecutive patients with stage III-IV squamous cell carcinoma of the head and neck entered a pilot study of sequential and synchronous chemo-radiotherapy. The study was planned as follows: two cycles of induction chemotherapy (MTX, BLM, DDP) followed by radical radiotherapy (66 Gy) with synchronous weekly administration of DDP (20 mg/m2) as a radiosensitizer. Out of the 39 patients evaluable for induction chemotherapy 25 (64%) achieved partial or complete response. Two patients underwent radical surgery after induction chemotherapy and 3 patients died of treatment. Out of the remaining 34 patients, 25 were untreated and 9 presented recurrence after primary surgery. Grade 4 mucositis was the major side effect of concurrent chemo-radiotherapy. Local control after synchronous therapy was obtained in 11 (44%) previously untreated patients and only in 1 (11%) patient of the surgically pre-treated group. At the time of the analysis 11 patients were alive, 8 of them free from disease (4 after salvage surgery). Actuarial 2-year survival for previously untreated patients was 33% and 24% for all the patients. This survival is not significantly different (log rank test) from that of a similar group of 24 patients treated at the same institution with radiotherapy alone. The important toxicity of the induction chemotherapy regimen and the poor 2-year survival do not show any benefit from such a combined approach in locally advanced head and neck carcinoma. Nevertheless, despite our disappointing results many data in the literature suggest a role for chemotherapy-based treatments of locally advanced head and neck cancer. Further controlled randomized studies are required to better define the place of chemotherapy in the multi-modality management of stage III-IV head and neck cancer.

Original languageEnglish
Pages (from-to)238-243
Number of pages6
JournalTumori
Volume76
Issue number3
Publication statusPublished - 1990

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Neck
Radiotherapy
Head
Carcinoma
Induction Chemotherapy
Head and Neck Neoplasms
Survival
Drug Therapy
Mucositis
Therapeutics
Recurrence

ASJC Scopus subject areas

  • Cancer Research

Cite this

Antognoni, P., Camesasca, G., Bianchi, C., Nicoletti, G., & Villa, E. (1990). Sequential and synchronous chemo-radiotherapy in the management of locally advanced carcinoma of the head and neck. Tumori, 76(3), 238-243.

Sequential and synchronous chemo-radiotherapy in the management of locally advanced carcinoma of the head and neck. / Antognoni, P.; Camesasca, G.; Bianchi, C.; Nicoletti, G.; Villa, E.

In: Tumori, Vol. 76, No. 3, 1990, p. 238-243.

Research output: Contribution to journalArticle

Antognoni, P, Camesasca, G, Bianchi, C, Nicoletti, G & Villa, E 1990, 'Sequential and synchronous chemo-radiotherapy in the management of locally advanced carcinoma of the head and neck', Tumori, vol. 76, no. 3, pp. 238-243.
Antognoni P, Camesasca G, Bianchi C, Nicoletti G, Villa E. Sequential and synchronous chemo-radiotherapy in the management of locally advanced carcinoma of the head and neck. Tumori. 1990;76(3):238-243.
Antognoni, P. ; Camesasca, G. ; Bianchi, C. ; Nicoletti, G. ; Villa, E. / Sequential and synchronous chemo-radiotherapy in the management of locally advanced carcinoma of the head and neck. In: Tumori. 1990 ; Vol. 76, No. 3. pp. 238-243.
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