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Alternating chemotherapy: gemcitabine and cisplatin with concurrent radiotherapy for treatment of advanced head and neck cancer.
- Source :
-
Oral oncology [Oral Oncol] 2013 Mar; Vol. 49 (3), pp. 249-54. Date of Electronic Publication: 2012 Oct 06. - Publication Year :
- 2013
-
Abstract
- Background: Many studies have shown gemcitabine and cisplatin are radiosensitizers. Concurrent chemoradiation seems to be an efficient approach for treatment of advanced head and neck cancer (HNC), but toxicity is significant.<br />Objective: To evaluate safety and explore efficacy of alternating chemotherapy with gemcitabine and cisplatin concurrent with radiotherapy in patients with advanced non-metastatic HNC.<br />Patients and Methods: Twenty-eight patients diagnosed with advanced Squamous Cell Carcinomas of the Head and Neck (SCCHN) in stages III (28%), IVa (36%), and IVb (36%) were treated with gemcitabine: 100mg/m(2) alternating with cisplatin: 50mg/m(2) concurrent with radiotherapy at doses of 2 Gy/day until completing 70 Gy. While awaiting for concurrent treatment, eleven patients received induction chemotherapy with cisplatin: 100mg/m(2) and 5-FU: 1000 mg/m(2). Toxicity, especially in relation to mucositis, xerostomy, dysphagia, leucopenia and radiodermitis was evaluated.<br />Results: 5-year progression-free survival was 27.8 ± 17.2% (CI-95: 0-61.5) and overall survival was 55.9 ± 11% (CI: 34.4-77.5). Overall response rate was 93%; complete response was 64.3% and partial response was 28.6%. Extensive surgery for primary site was avoided in 19 patients (70.4%). Grade 3-4 adverse events were mucositis (46.4%), leucopenia (14.2%), dysphagia (25%), xerostomy (10.7%) and radiodermitis (3.6%). Response rates and toxicity were not significantly different among those patients with and without induction chemotherapy, but survival was higher in patients receiving induction.<br />Conclusions: Gemcitabine alternating with cisplatin concurrent with radiotherapy is an active and safe treatment that deserves further study.<br /> (Copyright © 2012 Elsevier Ltd. All rights reserved.)
- Subjects :
- Adult
Antimetabolites, Antineoplastic administration & dosage
Antineoplastic Agents administration & dosage
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Carcinoma, Squamous Cell radiotherapy
Cisplatin administration & dosage
Deglutition Disorders chemically induced
Deoxycytidine therapeutic use
Disease Progression
Female
Fluorouracil administration & dosage
Follow-Up Studies
Head and Neck Neoplasms radiotherapy
Humans
Induction Chemotherapy methods
Leukopenia chemically induced
Male
Middle Aged
Neoplasm Staging
Radiodermatitis etiology
Radiotherapy Dosage
Remission Induction
Safety
Stomatitis chemically induced
Survival Rate
Treatment Outcome
Xerostomia chemically induced
Gemcitabine
Antimetabolites, Antineoplastic therapeutic use
Antineoplastic Agents therapeutic use
Carcinoma, Squamous Cell drug therapy
Chemoradiotherapy methods
Cisplatin therapeutic use
Deoxycytidine analogs & derivatives
Head and Neck Neoplasms drug therapy
Radiation-Sensitizing Agents therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1879-0593
- Volume :
- 49
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Oral oncology
- Publication Type :
- Academic Journal
- Accession number :
- 23043985
- Full Text :
- https://doi.org/10.1016/j.oraloncology.2012.09.008