title: [Concomitant association of radiotherapy and chemotherapy (CDDP 4-6 mg/m2/daily in continuous i.v. administration) in locally advanced ORL tumors].
abstract: In order to enhance radiation effects in the treatment of unresectable Head and Neck squamous cell carcinoma, we initiated a phase I-II study in February 1991 with concomitant radiation and cisplatin in the treatment of resectable Head and Neck squamous cell carcinoma. The first patient was treated in a palliative intend for a cervical recurrence (cutaneous metastatic lymphangitis) of laryngeal cancer. The seven other patients had a Stage IV M0, previously untreated, oropharyngeal carcinoma. Standard external radiation was carried out up to a total dose of 60 Gy/6 weeks (7 MeV electron beam) for the 1st patient and 72 Gy/8 weeks (Co60 beam) for the 7 other patients. Cisplatin was given during the entire radiation treatment, by continuous infusion, 5 days a week, at doses of 4 mg/m2/d for the 1st patient, 5 mg/m2/d for the two following patients and 6 mg/m2/d for the last five patients. One patient with a poor initial performance status (three in the WHO scale) stopped his treatment on the 6th week due to a grade 3 mucositis with deglutition pneumonia. He died 2 months later with progressive carcinoma. For one other patient, treatment was discontinued for 1 week after 48 Gy, due to a grade 3 mucositis. The other patients completed the planned protocol without any interruption. Mucositis (grade 3 in two cases, grade 2 in four cases), dermitis (grade 3 in two cases, grade 2 in four cases) and neutropenia (grade 2 in two cases) were the most frequent acute toxicity. Of the seven patients treated with a curative intend, six are free of disease at 6 to 28 months after completion of treatment. A pharmacokinetic study showed a total platinum accumulation. The mean value at the end of treatment reached 1157 ng/ml. Only one patient experienced an accumulation of the ultrafilterable platinum (137 ng/ml at the end of treatment).
authors.affiliation: Département de radiothérapie, centre Claudius-Regaud, Toulouse, France.
authors.forename: J M
authors.initials: JM
authors.lastname: Bachaud
authors.forename: N
authors.initials: N
authors.lastname: Albin
authors.forename: C
authors.initials: C
authors.lastname: Gay
authors.forename: E
authors.initials: E
authors.lastname: Chatelut
authors.forename: M
authors.initials: M
authors.lastname: Benchalal
authors.forename: J M
authors.initials: JM
authors.lastname: David
authors.forename: A
authors.initials: A
authors.lastname: Boneu
authors.forename: E
authors.initials: E
authors.lastname: Serrano
authors.forename: P
authors.initials: P
authors.lastname: Canal
authors.forename: N
authors.initials: N
authors.lastname: Daly-Schveitzer
mesh_terms: D000970:Antineoplastic Agents / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D003131:Combined Modality Therapy; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D010039:Otorhinolaryngologic Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D011879:Radiotherapy Dosage; D012074:Remission Induction
chemical_list: D000970:Antineoplastic Agents; D009944:Organoplatinum Compounds; C055423:didimethylsulfoxide dichloroplatinum(II)
vernacular_title: Association concomitante radio-chimiothérapie (CDDP 4-6 mg/m2/j en i.v. continu) dans les tumeurs ORL localement avancées.