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A pilot study of high-dose intraarterial cisplatin chemotherapy with concomitant accelerated radiotherapy for patients with previously untreated T4 and selected patients with T3N0-N3M0 squamous cell carcinoma of the upper aerodigestive tract
- Source :
- Cancer. 103:559-568
- Publication Year :
- 2005
- Publisher :
- Wiley, 2005.
-
Abstract
- BACKGROUND This Phase I clinical trial was developed to assess the feasibility of combining high-dose intraarterial cisplatin chemotherapy with concurrent, concomitant boost accelerated radiation therapy for patients with previously untreated T4 and select patients with T3N0–N3M0 squamous cell carcinoma of the upper aerodigestive tract. METHODS Between July 1999, and February 2002, 19 patients were treated with 3 or 4 weekly cycles of intraarterial Cisplatin chemotherapy (150 mg/m2) with concurrent, concomitant boost accelerated radiation therapy (72 grays in 42 fractions over 6 weeks). RESULTS Two patient deaths occurred among the first 15 patients enrolled. Both patients presented with febrile neutropenia, and both died of complications related to infection. The number of cycles of intraarterial cisplatin was reduced from four cycles to three cycles, and an additional four patients were treated. The fourth patient treated on the modified protocol developed febrile neutropenia, sepsis, and a thromboembolic event, which resulted in lower extremity amputations. The maximum acute toxicity experienced was Grade 2 in 6 patients, Grade 3 in 5 patients, Grade 4 in 6 patients, and Grade 5 in 2 patients. With a median follow-up of 21 months (range, 6.2–34.6 months), the overall survival at 1 year was 89.5% (95% confidence interval [95%CI], 76.7–100%). At 1 year, 92.9% of the patients were free from disease progression (95%CI, 80.3–100%). CONCLUSIONS The results of this study suggest that concurrent intraarterial cisplatin chemotherapy at a dose of 150 mg/m2 with concomitant boost accelerated radiation therapy is not feasible. Cancer 2005. © 2004 American Cancer Society.
- Subjects :
- Adult
Male
Cancer Research
medicine.medical_specialty
medicine.medical_treatment
Phases of clinical research
Antineoplastic Agents
Pilot Projects
Gastroenterology
Drug Administration Schedule
Internal medicine
medicine
Humans
Infusions, Intra-Arterial
Prospective Studies
Aged
Neoplasm Staging
Chemotherapy
business.industry
Cancer
Middle Aged
medicine.disease
Survival Analysis
Surgery
Radiation therapy
Treatment Outcome
Oncology
Epidermoid carcinoma
Chemotherapy, Adjuvant
Head and Neck Neoplasms
Concomitant
Carcinoma, Squamous Cell
Feasibility Studies
Female
Radiotherapy, Adjuvant
Dose Fractionation, Radiation
Cisplatin
Accelerated Radiation Therapy
business
Febrile neutropenia
Subjects
Details
- ISSN :
- 10970142 and 0008543X
- Volume :
- 103
- Database :
- OpenAIRE
- Journal :
- Cancer
- Accession number :
- edsair.doi.dedup.....204b84a7082ba1dd544d265f7e1692e8