z-logo
open-access-imgOpen Access
Intensity‐Modulated Radiation Therapy with Concurrent Carboplatin and Paclitaxel for Locally Advanced Head and Neck Cancer: Toxicities and Efficacy
Author(s) -
Vlacich Gregory,
Diaz Roberto,
Thorpe Steven W.,
Murphy Barbara A.,
Kirby Wyndee,
Sinard Robert J.,
Shakhtour Bashar,
Shyr Yu,
Murphy Patrick,
Netterville James L.,
Yarbrough Wendell G.,
Cmelak Anthony J.
Publication year - 2012
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2011-0396
Subject(s) - medicine , carboplatin , mucositis , taxane , regimen , head and neck cancer , tolerability , radiation therapy , induction chemotherapy , response evaluation criteria in solid tumors , chemotherapy , oncology , paclitaxel , surgery , cancer , urology , progressive disease , adverse effect , breast cancer , cisplatin
Background. Intensity‐modulated radiation therapy (IMRT) and alternative chemotherapy regimens strive to maintain efficacy while minimizing toxicity in locally advanced head and neck cancer (LAHNC) treatment. Our experience with concurrent IMRT and taxane‐based chemotherapy is presented. Methods. A retrospective review of 150 consecutive patients with LAHNC treated with IMRT and concurrent taxane‐based chemotherapy with curative intent was performed. The IMRT fractionation regimen consisted of 69.3 Gy to gross disease (2.1 Gy/fraction) and 56.1 Gy to prophylactic nodal sites (1.7 Gy/fraction). Weekly paclitaxel (30 mg/m 2 ) and carboplatin (area under the concentration–time curve [AUC], 1) were given concurrently to all patients, and 69% received weekly induction with paclitaxel (60 mg/m 2 ) and carboplatin (AUC, 2). Results. Over 90% of patients received the prescribed radiation dose. Ninety‐six percent completed five or more cycles of concurrent chemotherapy, with similar tolerability for induction chemotherapy. A percutaneous endoscopic gastrostomy (PEG) tube was required in 80 patients, with 10 maintaining PEG use >18 months. Acute grade 4 mucositis and dermatitis developed in 2.0% and 4.0% of patients, respectively. No patient experienced nadir sepsis, grade ≥3 late xerostomia, or significant nephropathy or gastrointestinal toxicity. Median follow‐up was 30 months. The 3‐year locoregional control rate was 83.2% with disease‐free survival and overall survival rates of 78.8% and 76.5%, respectively. Conclusion. Rates of acute and late toxicities were low, with excellent radiation dose delivery and impressive tumor control at 3 years, suggesting that concurrent carboplatin and paclitaxel with IMRT is a reasonable therapeutic option for the curative treatment of LAHNC.

The content you want is available to Zendy users.

Already have an account? Click here to sign in.
Having issues? You can contact us here