title: Weekly paclitaxel and carboplatin induction chemotherapy followed by concurrent chemoradiotherapy in locally advanced squamous cell carcinoma of the head and neck.
abstract: OBJECTIVE
  To perform a phase II trial evaluating dose dense induction chemotherapy for locally advanced head and neck cancer.
  
  
  METHODS
  Thirty-five patients received 6 weekly doses of carboplatin (area under the curve=2) and paclitaxel (135 mg/m) followed by concurrent weekly paclitaxel (40 mg/m) and carboplatin (area under the curve=1) and daily radiation (66-72 Gy).
  
  
  RESULTS
  There was 1 induction death from neutropenic sepsis and 1 sudden death during chemoradiotherapy. The overall response rate with induction was 79%. With >40 months of follow-up, the 36-month overall survival was 67% and squamous cell carcinoma of the head and neck survival 84%. Patients undergoing biopsy of the primary tumor site after the therapies had 17/18 (94%) pathologic complete response rate. The locoregional relapse rate was 40% (24 mo 28%) and distant relapse rate was 8% with only 1 distant site.
  
  
  CONCLUSIONS
  Therapy was active but patients must be carefully selected and monitored. Compared with the historical controls, dose dense and intense induction chemotherapy decreased distant failure rate without compromising the locoregional control.
authors.affiliation: Brown University Oncology Group, Providence, RI, USA.
authors.forename: Neal E
authors.initials: NE
authors.lastname: Ready
authors.forename: Ritesh
authors.initials: R
authors.lastname: Rathore
authors.forename: Tirrell T
authors.initials: TT
authors.lastname: Johnson
authors.forename: Ahmed
authors.initials: A
authors.lastname: Nadeem
authors.forename: Prakash
authors.initials: P
authors.lastname: Chougule
authors.forename: Charles
authors.initials: C
authors.lastname: Ruhl
authors.forename: Kathy
authors.initials: K
authors.lastname: Radie-Keane
authors.forename: Kathy
authors.initials: K
authors.lastname: Theall
authors.forename: Harold J
authors.initials: HJ
authors.lastname: Wanebo
authors.forename: Jennifer
authors.initials: J
authors.lastname: Marcello
authors.forename: Teresa
authors.initials: T
authors.lastname: Kennedy
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D019540:Area Under Curve; D016190:Carboplatin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D059186:Chemoradiotherapy, Adjuvant; D004334:Drug Administration Schedule; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy / Q000628:therapy*; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009367:Neoplasm Staging; D017239:Paclitaxel / Q000008:administration & dosage; D011879:Radiotherapy Dosage; D016896:Treatment Outcome
chemical_list: D016190:Carboplatin; D017239:Paclitaxel