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Targeted chemoradiation for advanced head and neck cancer: Analysis of 213 patients
Author(s) -
Robbins K. Thomas,
Kumar Parves,
Wong Frank S. H.,
Hartsell William F.,
Flick Pamela,
Palmer Robert,
Weir Alva B.,
Neill H. Barry,
Murry Thomas,
Ferguson Robert,
Hanchett Catherine,
Vieira Francisco,
Bush Andrew,
Howell Stephen B.
Publication year - 2000
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/1097-0347(200010)22:7<687::aid-hed8>3.0.co;2-w
Subject(s) - medicine , head and neck cancer , neck dissection , surgery , cancer , stage (stratigraphy) , carcinoma , oncology , radiation therapy , urology , paleontology , biology
Background To determine the survival results, patterns of relapse, and organ preservation effects of a targeted chemoradiation protocol for patients with advanced (stage III–IV) carcinoma of the head and neck. Methods Analysis of 213 patients with stage III–IV squamous cell carcinoma treated at UT Memphis between June 1993 and March 1998. Treatment included weekly intra‐arterial infusions of cisplatin (150 mg/m 2 / week × 4) rapidly delivered to the tumor bulk, simultaneous intravenous thiosulfate for systemic drug neutralization, and conventional external‐beam irradiation (180–200 cGy/fraction) to a total dose of 68–72 Gy. Results Tumor response, toxicity, disease control above the clavicle, pattern of relapse, and survival. There were 89 events of grade III–IV toxicity and 6 treatment‐related deaths (grade V). Complete response in the primary and regional sites was obtained in 171 of 213 (80%) and 92 of 151 (61%), respectively. The rate of clearance of regional disease after neck dissection was 98%. There were 51 of 195 recurrences (26%): 11 local (5.6%), 5 regional (2.6%), and 35 distant (17.9%). The Kaplan Meier plot projections for overall and cancer‐related 5‐year survival was 38.8% and 53.6%, respectively, whereas disease control above the clavicle was 74.3%. Conclusions We believe this chemoradiation protocol represents an effective management scheme for patients with advanced head and neck cancer with a high rate of organ preservation and possibly improved survival. © 2000 John Wiley & Sons, Inc. Head Neck 22: 687–693, 2000.