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Simultaneous chemoradiotherapy as salvage treatment in locoregional recurrences of squamous head and neck cancer
Author(s) -
Gandia Daniel,
Wibault Pierre,
Guillot Thierry,
Bensmaine Amine,
Armand Jean P.,
Marandas Patrick,
Luboinski Bernard,
Cvitkovic Esteban
Publication year - 1993
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/hed.2880150103
Subject(s) - medicine , mucositis , chemoradiotherapy , radiation therapy , head and neck cancer , asymptomatic , surgery , toxicity , cancer , brachytherapy , progressive disease , fluorouracil , chemotherapy
This study was designed to determine if long‐term palliation could be obtained in pre‐irradiated locoregional recurrent squamous head and neck cancer patients, with the administration of simultaneous chemoradiotherapy. Mandatory eligibility criteria were histologically documented squamous head and neck cancer in previously irradiated territory, surgical or brachytherapy salvage unfeasibility, or patient refusal. The protocol consisted of radiotherapy, at a rate of 5 daily fractions of 2 Gy on altermate weeks, with simultaneous continuous intravenous infusion of 5‐fluorouracil (5FU) at 800 mg/m 2 and oral hydroxyurea (HU) at 1.000–1,500 mg/day for 5 days. Tolerance was good. Acute toxicity was low with no grade ‐⩾ III WHO hematologic toxicity observed. Nine patients had grade III mucositis, one had grade IV, three had grade III skin toxicity, and only four patients required a 20% to 30% 5FU dose reduction because of it. Two patients had hand and foot syndrome, and two had asymptomatic 5FU‐related cardiac signs (1 ECG, 1 echographic + ECG). Chronic radiotherapy‐related effects consisted of Her mitte's sign observed in two patients. Of 34 registered patients, 33 were evaluable for response. An overall rate of 55% (18 patients) of objective responses [complete response (CR) + partial response (PR)] was obtained, with 12 patients (36%) achieving local control of disease. The median survival was 11 months. These data show that palliation could be obtained for the majority of responding patients, and also suggest an improvement in the immediate prognosis with this type of salvage procedure for a selected group of recurrent squamous head and neck cancer patients.