This is an archive of papers published by the staff and faculty of Fox Chase Cancer Center. For questions about content, please contact Talbot Research Library
Last updated on
Kramer NM , Horwitz EM , Cheng J , Ridge JA , Feigenberg SJ , Cohen RB , Nicolaou N , Sherman EJ , Babb JS , Damsker JA , Langer CJ
Toxicity and outcome analysis of patients with recurrent head and neck cancer treated with hyperfractionated split-course reirradiation and concurrent cisplatln and paclitaxel chemotherapy from two prospective phase I and II studies
Head and Neck. 2005 ;27(5) :406-414
AbstractBackground. Patients with local recurrences or new head and neck primary tumors in previously irradiated tissues have few options for salvage treatment. One option for select patients is to undergo reirradiation with concurrent chemotherapy. The purpose of this study is to report the initial clinical results of the Fox Chase phase I and II prospective reirradiation and chemotherapy studies. Methods. Between July 1996 and January 2002, 38 patients with locally recurrent unresectable squamous cell carcinoma of the head and neck were treated with concurrent chemotherapy and reirradiation on two prospective trials. All patients had received prior radiation therapy to the head and neck region (median dose, 64.2 Gy). Patients received cisplatin and paclitaxel along with hyperfractionated external beam radiation therapy to the site of recurrence. Results. The median follow-up was 10 months. The median survival was 12.4 months, with actuarial rates of overall survival of 50% and 35% at 1 and 2 years, respectively. During follow-up, 63% of patients experienced local progression of disease, all in the irradiated field. Actuarial progression-free survival at 1 year was 33%, with a median time to progression of 7.3 months. Acute grade 3 to 4 toxicity included neutropenia, nausea, emesis, and mucositis. Conclusions. Hyperfractionated split-course reirradiation and concurrent cisplatin and paclitaxel chemotherapy demonstrates durable locoregional control in select patients, although late toxicity may occasionally be significant. Only sites of disease recurrence need to be covered in the reirradiation fields. © 2005 Wiley Periodicals, Inc.
Notes10433074 (ISSN) Cited By: 1; Export Date: 25 May 2006; Source: Scopus CODEN: HEANE; DOI: 10.1002/hed.20163 Language of Original Document: English Correspondence Address: Horwitz, E.M.; Department of Radiation Oncology; Fox Chase Cancer Center; 333 Cottman Avenue Philadelphia, PA 19111-2497, United States; email: firstname.lastname@example.org References: Hong, W.K., Bromer, R., Chemotherapy in head and neck cancer (1983) N Engl J Med, 308, pp. 75-79; Kish, J.A., Weaver, A., Jacobs, J., Cummings, G., Al-Sarraf, M., Cisplatin and 5-fluorouracil infusion in patients with recurrent and disseminated epidermoid cancer of the head and neck (1984) Cancer, 53, pp. 1819-1824; Emami, B., Bignardi, M., Spector, G.J., Devineni, V.R., Hederman, M.A., Reirradiation of recurrent head and neck cancers (1987) Laryngoscope, 97, pp. 85-88; Langlois, D., Eschwege, P., Kramar, A., Richard, J.M., Reirradiation of head and neck cancers. Presentation of 35 cases treated at the Gustave Roussy Institute (1985) Radiother Oncol, 3, pp. 27-33; Pomp, J., Levendag, P.C., Van Putten, W.L., Reirradiation of recurrent tumors in the head and neck (1988) Am J Clin Oncol, 11, pp. 543-549; Skolyszewski, J., Korzeniowski, S., Reinfuss, M., The reirradiation of recurrences of and neck cancer (1980) Br J Radiol, 53, pp. 462-465; Jeremic, B., Djuric, L., Mijatovic, L., Incidence of radiation myelitis of the cervical spinal cord at doses of 5500 cGy or greater (1991) Cancer, 68, pp. 2138-2141; Stevens Jr., K.R., Britsch, A., Moss, W.T., High-dose reirradiation of head and neck cancer with curative intent (1994) Int J Radiat Oncol Biol Phys, 29, pp. 687-698; Emami, B., Marks, J.E., Retreatment of recurrent carcinoma of the head and neck by afterloading interstitial 192Ir implant (1983) Laryngoscope, 93, pp. 1345-1347; Yokes, E.E., Haraf, D.J., Mick, R., McEvilly, J.M., Weichselbaum, R.R., Intensified concomitant chemoradiotherapy with and without filgrastim for poor-prognosis head and neck cancer (1994) J Clin Oncol, 12, pp. 2351-2359; Coughlin, C.T., Richmond, R.C., Biologic and clinical developments of cisplatin combined with radiation: Concepts, utility, projections for new trials, and the emergence of carboplatin (1989) Semin Oncol, 16 (4 SUPPL. 6), pp. 31-43; Brizel, D.M., Albers, M.E., Fisher, S.R., Hyperfractionated irradiation with or without concurrent chemotherapy for locally advanced head and neck cancer (1998) N Engl J Med, 338, pp. 1798-1804; Fu, K.K., Pajak, T.F., Trotti, A., A Radiation Therapy Oncology Group (RTOG) phase III randomized study to compare hyperfractionation and two variants of accelerated fractionation to standard fractionation radiotherapy for head and neck squamous cell carcinomas: First report of RTOG 9003 (2000) Int J Radiat Oncol Biol Phys, 48, pp. 7-16; Forastiere, A.A., Goepfert, H., Maor, M., Concurrent chemotherapy and radiotherapy for organ preservation in advanced laryngeal cancer (2003) N Engl J Med, 349, pp. 2091-2098; Yokes, E.E., Moormeier, J.A., Ratain, M.J., 5-Fluorouracil, leucovorin, hydroxyurea, and escalating doses of continuous-infusion cisplatin with concomitant radiotherapy: A clinical and pharmacologic study (1992) Cancer Chemother Pharmacol, 29, pp. 178-184; Schaake-Koning, C., Van Den Bogaert, W., Dalesio, O., Effects of concomitant cisplatin and radiotherapy on inoperable non-small-cell lung cancer (1992) N Engl J Med, 326, pp. 524-530; Tishler, R.B., Geard, C.R., Hall, E.J., Schiff, P.B., Taxol sensitizes human astrocytoma cells to radiation (1992) Cancer Res, 52, pp. 3495-3497; Choy, H., Browne, M.J., Paclitaxel as a radiation sensitizer in non-small cell lung cancer (1995) Semin Oncol, 22 (3 SUPPL. 6), pp. 70-74; Chang, A.Y., Kim, K., Click, J., Anderson, T., Karp, D., Johnson, D., Phase II study of taxol, merbarone, and piroxantrone in stage IV non-small-cell lung cancer: The Eastern Cooperative Oncology Group Results (1993) J Natl Cancer Inst, pp. 85388-85394; Jacobs, C., Lyman, G., Velez-Garcia, E., A phase III randomized study comparing cisplatin and fluorouracil as single agents and in combination for advanced squamous cell carcinoma of the head and neck (1992) J Clin Oncol, 10, pp. 257-263; Klastersky, J., Sculier, J.P., Bureau, G., Cisplatin versus cisplatin plus etoposide in the treatment of advanced non-small-cell lung cancer (1989) J Clin Oncol, 7, pp. 1087-1092, Lung Cancer Working Party, Belgium; Klastersky, J., Sculier, J.P., Ravez, P., A randomized study comparing a high and a standard dose of cisplatin in combination with etoposide in the treatment of advanced non-small-cell lung carcinoma (1986) J Clin Oncol, 4, pp. 1780-1786; Forastiere, A.A., Metch, B., Schuller, D.E., Randomized comparison of cisplatin plus fluorouracil and carboplatin plus fluorouracil versus methotrexate in advanced squamous-cell carcinoma of the head and neck: A Southwest Oncology Group study (1992) J Clin Oncol, 10, pp. 1245-1251; Forastiere, A.A., Use of paclitaxel (Taxol) in squamous cell carcinoma of the head and neck (1993) Semin Oncol, 20 (4 SUPPL. 3), pp. 56-60; Kaplan, E.L., Meier, P., Nonparametric estimation from incomplete observations (1958) J Am Stat Assoc, 53, pp. 457-481; Ridge, J.A., Squamous cancer of the head and neck: Surgical treatment of local and regional recurrence (1993) Semin Oncol, 20, pp. 419-429; Williams, R.G., Recurrent head and neck cancer: The results of treatment (1974) Br J Surg, 61, pp. 691-697; Wang, C.C., Re-irradiation of recurrent nasopharyngeal carcinoma - Treatment techniques and results (1987) Int J Radiat Oncol Biol Phys, 13, pp. 953-956; Haraf, D.J., Weichselbaum, R.R., Yokes, E.E., Re-irradiation with concomitant chemotherapy of unresectable recurrent head and neck cancer: A potentially curable disease (1996) Ann Oncol, 7, pp. 913-918; Chmura, S.J., Yokes, E.E., Garofalo, M., Long-term outcome of re-irradiation with concomitant chemotherapy for locally recurrent squamous cell carcinoma of the head and neck (2003) Int J Radiat Oncol Biol Phys, 57 (2 SUPPL.), pp. S409-S410; Spencer, S.A., Harris, J., Wheeler, R.H., RTOG 96-10: Reirradiation with concurrent hydroxyurea and 5-fluorouracil in patients with squamous cell cancer of the head and neck (2001) Int J Radiat Oncol Biol Phys, 51, pp. 1299-1304; Spencer, S., Wheeler, R., Peters, G., Phase 1 trial of combined chemotherapy and reirradiation for recurrent unresectable head and neck cancer (2003) Head Neck, 25, pp. 118-122.