Concurrent chemoradiotherapy with weekly paclitaxel and carboplatin for locally advanced head and neck cancer: Long‐term follow‐up of a Brown University Oncology Group Phase II Study (HN‐53)

Abstract

Concurrent paclitaxel, carboplatin, and RT for advanced head and neck cancer results in high complete response rates. Long-term follow-up has revealed the curative potential of this regimen, though the doses used resulted in unacceptable toxicity.

Definitive radiochemotherapy of advanced head and neck cancer with carboplatin and paclitaxel

“…The combination of platinum and paclitaxel has been tested by several groups in phase II studies. Because of severe mucosal toxicity reported by Chogule et al [6], the recommended weekly paclitaxel dose was adjusted from the initial 60 mg/m 2 to 40 mg/m 2 together with carboplatin weekly AUC 1 and conventionally fractionated radiotherapy. The authors observed promising rates of survival and locoregional control.…”

“…Paclitaxel -representative of the second generation chemotherapy -has been used in SCCHN single-agent [7,14] or platinum-based radiochemotherapy protocols [2,6,8,15,22,25]. Current treatment strategies often use hyperfractionated or hyperfractionated-accelerated radiotherapy protocols to enhance efficacy.…”

Efficacy of Carboplatin/Paclitaxel-Based Radiochemotherapy in Locally Advanced Squamous Cell Carcinoma of Head and Neck

“…Chougule et al [18] postulated curative impact using CarboTaxol with RT with lower rates of toxicity than using cisplatin. However, despite this, they found that the doses used (carboplatin AUC1 and paclitaxel 60 mg/m²) led to high cumulative toxicity: 37 from 41 patients (90%) developed grade 3/4 mucositis.…”

“…Most institutions use cisplatin as their gold-standard chemotherapeutic agent. Nevertheless, several studies describe limited experience with CarboTaxol and RT for SCCHN [18,19,20,21,40,41]. …”

“…The toxicity profile of combined RCTX is relatively higher than for RT alone and may result in hospitalization, reduction of CTX doses or even treatment pauses. Several studies have reported the safety and efficacy of concurrent CTX in LASCCHN [17,18,19,20,21,22]. However, the value of CTX regimens other than cisplatin for LASCCHN has not been well established.…”