Concomitant Cisplatin Significantly Improves Locoregional Control in Advanced Head and Neck Cancers Treated With Hyperfractionated Radiotherapy

Huguenin, P; Beer, Karl; Allal, Abdelkarim Said; Rufibach, Kaspar; Friedli, Corinne; Davis, J.B.; Paulweber, Bernhard; Schmid, Stephan; Thöni, Armin; Ozşahin, Mahmut; Bernier, Jacques; Töpfer, Michael; Kann, Roger; Meier, Urs R.; Thum, P; Bieri, Sabine; Notter, Markus; Lombriser, Norbert; Glanzmann, Christoph

doi:10.1200/jco.2004.12.193

Cited by 231 publications

(135 citation statements)

References 23 publications

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“…Huguenin et al employed 2 cycles of Cisplatin which was divided into five doses of Cisplatin 20 mg/m 2 given daily [5]. The results of this study suggest less systemic toxicity and mucositis without compromising local control and overall survival.…”

mentioning

confidence: 63%

Dose intensity comparison between weekly and 3-weekly Cisplatin delivered concurrently with radical radiotherapy for head and neck cancer: A retrospective comparison from New Cross Hospital, Wolverhampton, UK

Swindell

Brammer

2008

Acta Oncologica

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mentioning

confidence: 63%

Dose intensity comparison between weekly and 3-weekly Cisplatin delivered concurrently with radical radiotherapy for head and neck cancer: A retrospective comparison from New Cross Hospital, Wolverhampton, UK

Swindell

Brammer

2008

Acta Oncologica

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“…However, the concomitant regimen used weekly carboplatin, a therapy that is not standard and unproven by a phase III trial, and could be potentially suboptimal therefore underestimating the results associated with the arm without docetaxel in the IC regimen. In many published trials [12,[34][35][36][37][38], head and neck tumors are treated by CRT with 2-3 cycles of high dose cisplatin. In fact, many ongoing trials use cisplatin as the standard arm in randomized trials of head and neck cancer where concurrent chemoradiation is part of the definitive treatment.…”

Section: Discussionmentioning

confidence: 99%

Induction Chemotherapy Followed by Concomitant Chemoradiation in Head and Neck Squamous Cell Carcinoma: A Single Institution Experience

Delouya¹,

Clavel²,

El-Bared³

2012

otolaryngol

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The role of IC is not yet clear as there is no published phase III trial comparing the standard treatment of CRT versus IC followed by CRT. Two individual trials have shown a survival benefit for IC followed by local treatment over local treatment alone [16][17][18]. However, the local treatment in those trials did not consist of CRT but rather of surgery plus radiotherapy or radiotherapy alone.More recently, phase III studies from the EORTC/TAX study group comparing two IC regimens consisting of cisplatin and fluorouracil with or without docetaxel followed by CRT in patients with unresectable squamous cell carcinoma of the head and neck found a significant improvement in the progression free and overall survival with inclusion of docetaxel. A phase III trial GORTEC 2000-01 [19] comparing docetaxel, cisplatin and fluorouracil (TPF) with cisplatinfluorouracil as induction chemotherapy demonstrated that TPF was superior to the cisplatin-fluorouracil regimen in terms of overall RR (80.0 versus 59.2%) and 3-year actuarial larynx preservation rate Abstract Objective: Phase 3 studies are underway to compare induction chemotherapy (IC) followed by concomitant chemoradiation (CRT) with CRT alone in advanced head and neck cancer. The purpose is to report the outcome of patients with advanced head and neck cancer treated at Centre Hospitalier de l'Université de Montréal (CHUM) with IC followed by CRT. Methods:From March 1998 to December 2007, 56 consecutive patients were treated for advanced squamous cell carcinoma of the head and neck with high-dose IC followed by CRT. Sixteen patients with carcinoma of the nasopharynx, paranasal sinuses or nasal cavity were excluded. Patients presented with either T4 (60%) or N3 (60%) disease. Outcomes were computed using Kaplan-Meier curves. The number of IC cycles were compared with logrank tests. Results:The 2 year estimates of OS, DFS, LRC and DMFS rates were 58%, 46%, 78% and 75% respectively. At last follow-up, we observed 17 patients with relapse of which 10 were at a distant site. When stratified by the number of IC cycles, a DMFS rate of 87% was observed for 1-2 cycles vs 49% for 3 cycles, p=0.05. Conclusions:Despite intensive treatment with platinum based IC and CRT, prognosis for this highly advanced population of T4 or N3 cancers is poor. The number of IC cycles seem to influence the rate of DM. Further trials are needed to answer the question regarding IC followed by CRT vs CRT alone. Targeted therapies might also yield more promising results.

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“…1 Most patients with HNC present with locally advanced disease, 2 diminishing their chance for a cure. Several clinical trials [3][4][5][6][7] and meta-analyses 8,9 established that adding cisplatin concurrently to radiation improved the rates of locoregional control, organ preservation, and/or survival for patients with HNC. Four recently reported randomized trials established new therapy options.…”

Section: Introductionmentioning

confidence: 99%

Head and neck carcinoma in the United States

Ang¹,

Chen²,

Curran³

et al. 2012

Cancer

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BACKGROUND: Detailed information about how patients with head and neck carcinoma (HNC) are treated across practice settings does not exist. The authors conducted a prospective, observational study to examine the patterns of care for a series of patients with newly diagnosed HNC in the United States and to test 2 hypotheses: 1) There is no difference in the pattern of care between community and academic settings; and 2) the results of major randomized clinical trials will change the pattern of care in both practice settings within 1 year of publication in peer-reviewed journals. METHODS: Patients aged !18 years were enrolled in the Longitudinal Oncology Registry of Head and Neck Carcinoma (LORHAN) after providing written informed consent if they had a confirmed diagnosis of new HNC and were scheduled to receive treatment other than surgery alone. RESULTS: Between 2005 and 2010, 100 centers enrolled 4243 patients, including 2612 patients (62%) from academic investigators and 1631 patients (38%) from community centers. Initial treatments were radiation with concurrent chemotherapy (30%) or cetuximab (9%), adjuvant radiotherapy (21%), induction chemotherapy (16%), and other (24%). Intensity modulated radiation therapy was the dominant radiation technique (84%). Singleagent cisplatin was prescribed in nearly half of patients and more often in academic centers (53% vs 43% of patients; P < .0001). Single-agent cetuximab was the next most common drug used (19%) and was prescribed more frequently in community settings (24% vs 17%; P ¼ .0001). The data rejected the 2 prospective hypotheses. CONCLUSIONS: LORHAN documented differences in patient characteristics and treatments between community and academic settings for a large series of patients in the United States. Cancer 2012;118:5783-92.

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Concomitant Cisplatin Significantly Improves Locoregional Control in Advanced Head and Neck Cancers Treated With Hyperfractionated Radiotherapy

Abstract: The therapeutic index of hyperfractionated radiotherapy is improved by concomitant cisplatin.

Cited by 231 publications

References 23 publications

Dose intensity comparison between weekly and 3-weekly Cisplatin delivered concurrently with radical radiotherapy for head and neck cancer: A retrospective comparison from New Cross Hospital, Wolverhampton, UK

Dose intensity comparison between weekly and 3-weekly Cisplatin delivered concurrently with radical radiotherapy for head and neck cancer: A retrospective comparison from New Cross Hospital, Wolverhampton, UK

Induction Chemotherapy Followed by Concomitant Chemoradiation in Head and Neck Squamous Cell Carcinoma: A Single Institution Experience

Head and neck carcinoma in the United States

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