Simultaneous radiation therapy and cisplatin chemotherapy in advanced cancer of the head and neck. A pilot study at Tygerberg Hospital, Parowvallei, South Africa.
Fifty patients with advanced carcinoma of the head and neck were treated in a nonrandomized pilot study utilizing simultaneous cisplatin and radiotherapy. Treatment was delivered in two segments. The initial partial course (PC) consisted of 75-100 mg/m2 of cisplatin and concomitant radio-therapy to 20.00 Gy in 1 week, with 4-week split. Patients who tolerated therapy and experienced at least a partial response (PR) went on to complete the full course of therapy (FC), with the second phase consisting of 120 mg/m2 of cisplatin and 38.40 Gy of radiation. Total cisplatin delivered ranged between 195 and 220 mg/m2, and the total radiation dose was 58.40 Gy. Of 38 evaluable patients, 31 (82%) had at least a partial response (PR). However, at time of analysis 20 months after study, 27 (71%) patients were alive with disease or dead. Mean disease-free survival (DFS) for patients receiving FC therapy (10.05 months) was greater than that for patients who received only PC therapy (2.65 months), but the difference in overall survival (OS) was not statistically significant (11.95 FC versus 10.29 PC). Response rates and the minimal toxicity are within the range of other reported studies. Randomized studies should seek optimal time-dose schedule and establish advantages in terms of crude survival and disease-free survival.
McDonald
S
S
University of Rochester Cancer Center, Department of Radiation Oncology, New York 14642.
Mills
E E
EE
Van der Merwe
A M
AM
Rubin
P
P
Lush
C M
CM
D000293:Adolescent; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000627:therapeutic use*; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000532:radiotherapy*; D006801:Humans; D007262:Infusions, Intravenous; D008207:Lymphatic Metastasis; D008875:Middle Aged; D010865:Pilot Projects; D011867:Radioisotope Teletherapy; D011879:Radiotherapy Dosage; D013997:Time Factors
D003037:Cobalt Radioisotopes; D002945:Cisplatin